Individual
WADE MCCULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC
Contact information
Practice address
17355 BOONES FERRY RD, STE B, LAKE OSWEGO, OR 97035-5225
(503) 919-9091
Mailing address
1709 ASPEN CT, LAKE OSWEGO, OR 97034-6031
(503) 919-9091
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 01064
OR
Other
Enumeration date
07/09/2007
Last updated
12/16/2016
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