Individual
JENNIFER GAMACHE KEARNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DACM, LAC
Contact information
Practice address
4004 SE WOODSTOCK BLVD, PORTLAND, OR 97202-7662
(503) 777-0444
Mailing address
6214 SE 45TH AVE, PORTLAND, OR 97206-7029
(609) 477-9192
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
25MZ00048100
NJ
171100000X
Acupuncturist
Primary
AC01275
OR
171100000X
Acupuncturist
AK000846
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
364590178
TAX ID
NJ
05
—
500616924
—
OR
Enumeration date
12/15/2006
Last updated
05/25/2021
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