Organization
LAURELHURST FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE ANNA HABER L.AC. (OWNER)
(503) 928-2595
Entity
Organization
Contact information
Practice address
4410 NE GLISAN ST, PORTLAND, OR 97213-2331
(503) 470-5200
Mailing address
2706 SE LINCOLN ST, PORTLAND, OR 97214-5556
(503) 470-5200
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC153031
OK
171100000X
Acupuncturist
Primary
AC161513
OR
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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