Individual
PEGGY ENSIGN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
1920 NW JOHNSON ST, SUITE 10, PORTLAND, OR 97209-1325
(503) 274-0644
Mailing address
9340 N POLK AVE, PORTLAND, OR 97203-2324
(503) 287-6846
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00188
OR
Other
Enumeration date
05/01/2006
Last updated
07/08/2007
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