Organization
ELEMENTS HOLISTIC WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYCHELL VINCENT LAC (ACUPUNCTURIST)
(503) 656-5510
Entity
Organization
Contact information
Practice address
15240 SE 82ND DR, CLACKAMAS, OR 97015-9606
(503) 656-5510
Mailing address
15240 SE 82ND DR, CLACKAMAS, OR 97015
(503) 656-5510
(503) 656-8080
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC150496
OR
Other
Enumeration date
08/04/2011
Last updated
08/04/2011
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