Organization
TINY PINS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELEANOR ELIZABETH LEGARE LAC (OWNER)
(503) 314-9186
Entity
Organization
Contact information
Practice address
8514 SE STARK ST, PORTLAND, OR 97216-1140
(503) 314-9186
Mailing address
8514 SE STARK ST, PORTLAND, OR 97216-1140
(503) 314-9186
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
AC185850
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC185850
ACUPUNCTURE
OR
Enumeration date
03/14/2018
Last updated
03/14/2018
Update your record
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