Organization
DYNAMIC ACUPUNCTURE LLC
Active
Other names
Stephanie Grant Acupunture LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GREGORY LAC (OWNER, LICENSED ACUPUNCTURIST)
(503) 686-3059
Entity
Organization
Contact information
Practice address
1829 NE ALBERTA ST STE A, PORTLAND, OR 97211-5889
(503) 893-5711
(503) 296-5829
Mailing address
1829 NE ALBERTA ST STE A, PORTLAND, OR 97211-5889
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500721654
—
OR
Enumeration date
09/16/2019
Last updated
09/16/2019
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