Organization
AUTHENTIC HEALING WELLNESS PDX CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON CHAWLA LAC (OWNER)
(503) 998-2678
Entity
Organization
Contact information
Practice address
333 S FLOWER ST STE B, PORTLAND, OR 97239-3797
(503) 998-2678
Mailing address
333 S FLOWER ST STE B, PORTLAND, OR 97239-3797
(503) 998-2678
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00489
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376768093
NPI
OR
Enumeration date
05/04/2015
Last updated
02/26/2021
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