Individual
KIM WAYLAND LLEWELLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
5412 N WILLIAMS AVE, PORTLAND, OR 97217-2740
(971) 373-8378
Mailing address
5412 N WILLIAMS AVE, PORTLAND, OR 97217-2740
(971) 373-8378
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC150271
OR
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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