Individual
HAYLEY ELANA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
4515 SW CORBETT AVE, PORTLAND, OR 97239-4289
(503) 224-5464
(503) 222-9474
Mailing address
4515 SW CORBETT AVE, PORTLAND, OR 97239-4289
(503) 224-5464
(503) 222-9474
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC151170
OR
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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