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Individual

MR. DANIEL RAIDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC., MA.O.M.

Contact information

Practice address
2330 NW FLANDERS ST, SUITE 205, PORTLAND, OR 97210-3442
(503) 701-8766
Mailing address
20233 NW SAUVIE ISLAND RD, PORTLAND, OR 97231-1317
(503) 621-3146

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00624
OR

Other

Enumeration date
08/29/2007
Last updated
08/29/2007
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