Organization
WILD MOUNTAIN MEDICINE LLC
Active
Other names
Wild Mountain Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MADELINE CHAVEZ (OWNER)
(541) 944-1989
Entity
Organization
Contact information
Practice address
3863 SW HALL BLVD STE B, BEAVERTON, OR 97005-2042
(541) 944-1989
Mailing address
3863 SW HALL BLVD STE B, BEAVERTON, OR 97005-2042
(541) 944-1989
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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