Individual
BRAD HAROLD WHISNANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
10490 SW EASTRIDGE ST, PORTLAND, OR 97225-5030
(503) 750-6238
Mailing address
11160 SW WAVERLY PL, PORTLAND, OR 97225-4456
(503) 750-6238
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01151
OR
Other
Enumeration date
01/14/2008
Last updated
01/14/2008
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