Organization
TIFFANY'S APOTHEKE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY D PRADO L.AC. (OWNER)
(503) 705-5738
Entity
Organization
Contact information
Practice address
1983 NW FLANDERS ST, SUITE 109, PORTLAND, OR 97209
(503) 705-5738
Mailing address
7333 SE WOODWARD ST, PORTLAND, OR 97206
(503) 705-5738
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC156830
OR
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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