Individual
KENNETH GLOWACKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
7460 SW HUNZIKER ST STE D, TIGARD, OR 97223-8244
(503) 707-2702
Mailing address
8216 SW 42ND AVE, PORTLAND, OR 97219-3517
(503) 707-2702
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 1196
OR
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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