Individual
TAKASHI YAMAMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
1765 STATE ST, SALEM, OR 97301-4342
(503) 480-9697
Mailing address
1765 STATE ST, SALEM, OR 97301-4342
(503) 480-9697
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00912
OR
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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