Individual
SARA LUCILLE CARBONNEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1017 SW MORRISON ST STE 405, PORTLAND, OR 97205-2629
(301) 639-6917
Mailing address
1410 NE SCHUYLER ST APT 3, PORTLAND, OR 97212-4448
(301) 639-6917
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC190041
OR
Other
Enumeration date
11/18/2018
Last updated
11/18/2018
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