Organization
WOODSTOCK WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANGELA TISCI LAC (ACUPUNCTURIST)
(503) 777-2776
Entity
Organization
Contact information
Practice address
4512 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6274
(503) 777-2776
Mailing address
4512 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6274
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00513
OR
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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