# CALDERA ACUPUNCTURE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Caldera Acupuncture & Microneedling
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538884481
- **Authorized official:** CHRISTINA CLARK L.AC. (OWNER OPERATOR)
- **Authorized official phone:** (541) 961-7947

## Contact information

- **Practice address:** 1045 NW BOND ST STE 202, BEND, OR 97703-2064
- **Practice address phone:** (541) 961-7947
- **Mailing address:** 19926 PORCUPINE DR, BEND, OR 97702-2090
- **Mailing address phone:** (541) 961-7947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | Yes |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 10/04/2022
- **Last updated:** 10/04/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 205587 | STATE LICENSE | OR |
| 01 | — | 99088 | STATE LICENSE | MT |