Individual
EMILY COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DACM, MACOM, LAC
Contact information
Practice address
11775 SW GREENBURG RD, TIGARD, OR 97223-6445
(503) 381-2600
Mailing address
11495 SW GREENBURG RD APT B, TIGARD, OR 97223-5319
(315) 209-0983
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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