Individual
DANIELLE THERESA BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
5820 SW KELLY AVE, PORTLAND, OR 97239-3780
(503) 206-7034
Mailing address
5331 SW MACADAM AVE #514, STE 258, PORTLAND, OR 97239
(503) 206-7034
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC166580
OR
Other
Enumeration date
09/09/2014
Last updated
03/17/2016
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