Individual
MITESH MASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
200 NE 20TH AVE STE 220, PORTLAND, OR 97232-3094
(201) 988-2258
Mailing address
3439 NE SANDY BLVD # 425, PORTLAND, OR 97232-1959
(201) 988-2258
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC165628
OR
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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