Organization
EDWARD ILDOE BAE
Active
Organization
EDWARD ILDOE BAE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD ILDOE BAE L.AC. (SOLE PROPRIETOR)
(503) 646-3743
Entity
Organization
Contact information
Practice address
13755 SW FARMINGTON RD, BEAVERTON, OR 97005-2603
(503) 646-3743
(503) 646-5200
Mailing address
13755 SW FARMINGTON RD, BEAVERTON, OR 97005-2603
(503) 646-3743
(503) 646-5200
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC00115
OR
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/15/2013
Last updated
02/04/2014
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