Individual
TARA ELISE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1920 NW LOVEJOY ST, PORTLAND, OR 97209-1504
(503) 479-5506
Mailing address
826 N HUMBOLDT ST, APT. 3, PORTLAND, OR 97217-2549
(503) 479-5506
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC160506
OR
Other
Enumeration date
05/13/2013
Last updated
02/13/2015
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