Individual
MARY ANN GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
6913 SE FOSTER RD, PORTLAND, OR 97206-4547
(503) 235-7653
Mailing address
2800 N LOMBARD ST # 115, PORTLAND, OR 97217-6234
(971) 235-0680
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC202061
OR
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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