Individual
SHAHRZAD VOSSOUGHI FAKHRAVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
1125 NW 9TH AVE, SUITE 107B, PORTLAND, OR 97209-2864
(503) 482-9228
Mailing address
3458 SW DOSCHVIEW CT, PORTLAND, OR 97239-1487
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC152813
OR
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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