Organization
GREEN LOTUS ACUPUNCTURE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JEAN BRINKMAN (OWNER)
(503) 789-7661
Entity
Organization
Contact information
Practice address
2100 SE LAKE RD STE 1, MILWAUKIE, OR 97222-7759
(503) 789-7661
Mailing address
1208 SE LAMBERT ST APT 1, PORTLAND, OR 97202-6369
(503) 789-7661
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC153318
OR
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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