Individual
MAXX BRIDGET TANKLAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
3526 NE 57TH AVE, PORTLAND, OR 97213
(503) 335-9440
(503) 493-7281
Mailing address
3526 NE 57TH AVE, PORTLAND, OR 97213
(503) 335-9440
(503) 493-7281
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC217940
OR
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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