Individual
TARA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., FABORM
Contact information
Practice address
235 W D ST, JACKSONVILLE, OR 97530-0038
(541) 838-0980
Mailing address
PO BOX 895, JACKSONVILLE, OR 97530-0895
(541) 838-0980
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
16394
CA
171100000X
Acupuncturist
Primary
201642
OR
Other
Enumeration date
01/05/2016
Last updated
08/21/2024
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