Organization
LITTLE WING ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVI KEENOM LAC, MACOM (OWNER, PRACTITIONER)
(503) 224-2525
Entity
Organization
Contact information
Practice address
833 SW 11TH AVE, SUITE #1018, PORTLAND, OR 97205-2125
(503) 224-2525
(503) 224-3397
Mailing address
833 SW 11TH AVE, SUITE #1018, PORTLAND, OR 97205-2125
(503) 224-2525
(503) 224-3397
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC156429
OR
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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