Individual
JACOB ROCKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
4943 NE MLK BLVD, PORTLAND, OR 97211-3353
(971) 506-4236
Mailing address
2347 NE 8TH AVE, PORTLAND, OR 97212-3859
(971) 506-4236
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC203512
OR
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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