Individual
TABITHA ROCHELLE COSTIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1421 SE ANKENY ST, PORTLAND, OR 97214-1471
(503) 284-7996
Mailing address
22 SE 11TH AVE APT 512, PORTLAND, OR 97214-1393
(503) 888-1012
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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