Individual
MS. KAECEE CREVELING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., MACOM
Contact information
Practice address
1615 NW 23RD AVE, SUITE 1, PORTLAND, OR 97210-2557
(206) 910-8765
Mailing address
2214 NE 79TH AVE, PORTLAND, OR 97213-6618
(206) 910-8765
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC160521
OR
171100000X
Acupuncturist
AC60322012
WA
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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