Individual
ANGELA LEE TISCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
4512 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6274
(503) 777-2776
Mailing address
6535 SE HARNEY ST, PORTLAND, OR 97206-8855
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00513
OR
Other
Enumeration date
10/28/2006
Last updated
07/08/2007
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