Organization
AMANDA REAL, LAC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA DAWN REAL L.AC. (OWNER)
(503) 560-0963
Entity
Organization
Contact information
Practice address
8707 SE 9TH AVE, PORTLAND, OR 97202-7005
(503) 560-0963
Mailing address
8707 SE 9TH AVE, PORTLAND, OR 97202-7005
(503) 560-0963
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01226
OR
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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