Individual
MICHELLE WANEKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
3313 NE 70TH AVE, PORTLAND, OR 97213-5269
(907) 299-1187
Mailing address
3313 NE 70TH AVE, PORTLAND, OR 97213-5269
(907) 299-1187
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
181456
OR
Other
Enumeration date
04/21/2017
Last updated
09/02/2020
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