Organization
TRAVIS BUCKMASTER L.AC.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS LEE BUCKMASTER LAC (OWNER)
(503) 981-4591
Entity
Organization
Contact information
Practice address
559 GLATT CIR, WOODBURN, OR 97071-9675
(503) 981-4591
(503) 982-3308
Mailing address
559 GLATT CIR, WOODBURN, OR 97071-9675
(503) 981-4591
(503) 982-3308
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00588
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC00588
STATE LIC
OR
Enumeration date
04/17/2008
Last updated
04/17/2008
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