Individual
MS. SANDRA E. TADDESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.A.C.
Contact information
Practice address
506 NE 49TH AVE, PORTLAND, OR 97292
(503) 232-2500
(503) 232-2700
Mailing address
PO BOX 16402, PORTLAND, OR 97292
(503) 232-2500
(503) 232-2700
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC00002271
WA
171100000X
Acupuncturist
Primary
AC00663
OR
225700000X
Massage Therapist
7049
OR
Other
Enumeration date
02/27/2007
Last updated
11/15/2013
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