Organization
CLEAR HEART ACUPUNCTURE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BAUCUM LAC (OWNER)
(503) 395-5228
Entity
Organization
Contact information
Practice address
4605 NE FREMONT ST STE 103, PORTLAND, OR 97213-1708
(503) 395-5228
(844) 814-4767
Mailing address
PO BOX 86371, PORTLAND, OR 97286-0371
(503) 395-5228
(844) 814-4767
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC175542
OR
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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