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Individual

DR. REBECCA L PROVORSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ND, LAC

Contact information

Practice address
1435 NW 23RD AVE, SUITE 102, PORTLAND, OR 97210-2642
(503) 222-1865
(866) 842-8747
Mailing address
1435 NW 23RD AVE, SUITE 102, PORTLAND, OR 97210-2642
(503) 222-1865
(866) 842-8747

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00861
OR
175F00000X
Naturopath
1375
OR

Other

Enumeration date
05/23/2007
Last updated
09/11/2025
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