Individual
MARI PATRICE GREENLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
2311 E BURNSIDE ST STE 201, PORTLAND, OR 97214-1655
(503) 349-8122
(971) 319-2195
Mailing address
2311 E BURNSIDE ST STE 201, PORTLAND, OR 97214-1655
(503) 349-8122
(971) 319-2195
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00938
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900947265
TAX ID #
OR
Enumeration date
10/23/2006
Last updated
11/06/2019
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