Individual
DR. KACY LEANN BORBA SPANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D., LAC
Contact information
Practice address
3942 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5242
(712) 581-8539
Mailing address
3942 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5242
(971) 258-1853
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC167588
OR
174400000X
Specialist
20290
OR
175F00000X
Naturopath
Primary
2022
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500680362
—
OR
05
—
500688613
—
OR
Enumeration date
04/08/2014
Last updated
01/28/2022
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