Organization
WHITE PHOENIX ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLYNDRETH STEAD L.AC. (PRESIDENT & CEO)
(503) 235-7653
Entity
Organization
Contact information
Practice address
6913 SE FOSTER RD, PORTLAND, OR 97206-4547
(503) 235-7653
(866) 398-6092
Mailing address
6913 SE FOSTER RD, PORTLAND, OR 97206-4547
(503) 235-7653
(503) 398-6092
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
261Q00000X
Clinic/Center
Primary
1510566-3
OR
Other
Enumeration date
09/10/2012
Last updated
12/03/2020
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