Organization
JADE DRAGONFLY ACUPUNCTURE, LLC
Active
Other names
Shalena Havens
Organization subpart
No
Provider details
NPI number
Authorized official
SHALENA DAWN HAVENS L AC (PRESIDENT)
(503) 886-9708
Entity
Organization
Contact information
Practice address
310 SW 4TH AVE, SUITE 1008, PORTLAND, OR 97204-2345
(503) 886-9708
(503) 222-1819
Mailing address
310 SW 4TH AVE, SUITE 1008, PORTLAND, OR 97204-2345
(503) 886-9708
(503) 222-1819
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC90017
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851410070
NPI
—
Enumeration date
11/05/2008
Last updated
11/05/2008
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