Individual
MARK WAYNE TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
322 NW 5TH AVE, STE 305, PORTLAND, OR 97209-3825
(503) 481-9904
Mailing address
509 WASHINGTON ST, OREGON CITY, OR 97045-2243
(503) 481-9904
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC154188
OR
Other
Enumeration date
08/02/2012
Last updated
03/05/2014
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