Organization
ACCIDENT PAIN WELLNESS CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNY JUNG MSOM, L.AC. (PRESIDENT)
(503) 702-0927
Entity
Organization
Contact information
Practice address
4525 SW 109TH AVE, BEAVERTON, OR 97005-3022
(503) 702-0927
Mailing address
4525 SW 109TH AVE, BEAVERTON, OR 97005-3022
(503) 702-0927
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC150816
OR
175F00000X
Naturopath
4035
OR
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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