Organization
STARSIDE HEALING ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES RACHEL GREY LAC, LMT (OWNER)
(503) 956-0912
Entity
Organization
Contact information
Practice address
1308 NW 20TH AVE, SUITE 10, PORTLAND, OR 97209-1607
(503) 956-0912
(503) 715-4923
Mailing address
1308 NW 20TH AVE, SUITE 10, PORTLAND, OR 97209-1607
(503) 956-0912
(503) 715-4923
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01160
OR
Other
Enumeration date
05/18/2009
Last updated
03/20/2014
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