Organization
THE REWILDING PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MONTENEGRO (OWNER)
(909) 945-7756
Entity
Organization
Contact information
Practice address
7886 SE 13TH AVE, PORTLAND, OR 97202-6300
(503) 956-9396
Mailing address
PO BOX 86245, PORTLAND, OR 97286-0245
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
08/19/2025
Last updated
08/19/2025
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