Organization
BEVERLY M. MADISON L.AC. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY M. MADISON L.AC. (ACUPUNCTURISTS)
(503) 288-7661
Entity
Organization
Contact information
Practice address
2524 NE 39TH AVE, PORTLAND, OR 97212-2923
(503) 288-7661
Mailing address
2524 NE 39TH AVE, PORTLAND, OR 97212-2923
(503) 288-7661
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
100
OR
Other
Enumeration date
06/26/2007
Last updated
08/22/2020
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