Organization
HEAVEN-EARTH ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC GADOUA L.AC. (ACUPUNCTURIST)
(503) 872-9861
Entity
Organization
Contact information
Practice address
407 NE 12TH AVE STE 205, PORTLAND, OR 97232-2757
(503) 872-9861
Mailing address
407 NE 12TH AVE STE 205, PORTLAND, OR 97232-2757
(503) 872-9861
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
00208
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487682837
NPI 1
OR
Enumeration date
02/14/2012
Last updated
02/14/2012
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