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Individual

DR. JACQUELINE ELIESA STIVERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ND LAC

Contact information

Practice address
2318 NE MLK JR BLVD, PORTLAND, OR 97212-3715
(503) 335-8611
Mailing address
2318 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-3715
(503) 539-6832

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
OR
171100000X
Acupuncturist
AC190894
OR
175F00000X
Naturopath
Primary
4216
OR
208D00000X
General Practice Physician
4216
OR

Other

Enumeration date
10/09/2018
Last updated
06/01/2020
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