Organization
WANDERING STONE ACUPUNCTURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY ANN POLINKUS LAC (LAC)
(360) 223-4533
Entity
Organization
Contact information
Practice address
1524 NE HANCOCK ST APT 2, PORTLAND, OR 97212-4472
(360) 223-4533
Mailing address
1524 NE HANCOCK ST APT 2, PORTLAND, OR 97212-4472
(360) 223-4533
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500759468
—
OR
Enumeration date
08/23/2019
Last updated
08/23/2019
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