Organization
IMMERSION ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY LYNN NIGH ND/LAC (OWNER)
(503) 719-4806
Entity
Organization
Contact information
Practice address
1221 SE MADISON ST, PORTLAND, OR 97214-3890
(503) 719-4806
Mailing address
1221 SE MADISON ST, PORTLAND, OR 97214-3890
(503) 719-4806
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
05/09/2014
Last updated
05/12/2014
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