Individual
MRS. KAREN SUE BONAFEDE GAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
530 1ST ST, SUITE B-1, LAKE OSWEGO, OR 97034-3248
(503) 804-0133
(503) 594-1114
Mailing address
1380 7TH ST, WEST LINN, OR 97068-4718
(503) 234-6137
(503) 594-1114
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01193
OR
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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