Organization
FOREST MOUNTAIN CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHINICHI MORIYAMA L.AC. (PRACTITIONER)
(503) 419-8025
Entity
Organization
Contact information
Practice address
3939 NE HANCOCK ST STE 217, PORTLAND, OR 97212-5321
(503) 419-8025
(506) 288-7877
Mailing address
3939 NE HANCOCK ST STE 217, PORTLAND, OR 97212-5321
(503) 419-8025
(506) 288-7877
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC780
OR
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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