Individual
DOUG GROOTVELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 NE 78TH AVE, PORTLAND, OR 97213-6335
(971) 219-7250
Mailing address
100 NE 78TH AVE, PORTLAND, OR 97213-6335
(971) 219-7250
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00604
OR
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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