Organization
MILL-E-MOTO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN JOHN MILLEY MACOM, LAC (OWNER)
(503) 758-7108
Entity
Organization
Contact information
Practice address
4625 SW WASHINGTON AVE, BEAVERTON, OR 97005-0529
(503) 758-7108
Mailing address
4625 SW WASHINGTON AVE, BEAVERTON, OR 97005-0529
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00981
OR
Other
Enumeration date
12/17/2012
Last updated
12/17/2012
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