Individual
MISS ANITA TADAVARTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACOM, LAC
Contact information
Practice address
7110 SW FIR LOOP, SUITE 205, TIGARD, OR 97223-8084
(503) 819-2904
(503) 746-7432
Mailing address
7110 SW FIR LOOP, SUITE 205, TIGARD, OR 97223-8084
(503) 819-2904
(503) 746-7432
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01167
OR
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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