Individual
MR. JASON ARNIE LEISTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
56881 ENTERPRISE DR, SUNRIVER, OR 97707-2120
(541) 593-8535
Mailing address
PO BOX 3103, BEND, OR 97707-0103
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
160583
OR
Other
Enumeration date
04/23/2013
Last updated
09/22/2016
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