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Individual

TRAVIS KANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3125 NE HOLLADAY ST, SUITE A, PORTLAND, OR 97232-2504
(703) 220-1844
Mailing address
1025 NE 33RD AVE, PORTLAND, OR 97232-2518
(703) 220-1844

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC157031
OR

Other

Enumeration date
03/10/2012
Last updated
03/10/2012
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