Individual
SUSANNA FARAHAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 535-3800
Mailing address
3946 NE 12TH AVE, PORTLAND, OR 97212-1244
(443) 605-2986
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC169710
OR
Other
Enumeration date
10/17/2014
Last updated
10/26/2014
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