Individual
MS. ANDREA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
1403 SE 26TH AVE, PORTLAND, OR 97214-2966
(520) 403-5747
Mailing address
1403 SE 26TH AVE, PORTLAND, OR 97214-2966
(520) 403-5747
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC174443
OR
Other
Enumeration date
10/03/2015
Last updated
10/03/2015
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