Individual
MALLORY A HARMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
4233 S CORBETT AVE, PORTLAND, OR 97239-4203
(503) 482-9370
Mailing address
228 S WHITAKER ST, PORTLAND, OR 97239-4810
(406) 690-2003
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC189993
OR
171100000X
Acupuncturist
MED-ACU-LIC-74129
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500767031
—
OR
Enumeration date
03/29/2019
Last updated
03/09/2022
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