Individual
JUSTIN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
819 SE MORRISON ST STE 115, PORTLAND, OR 97214-6308
(503) 956-9396
Mailing address
5853 SW TERWILLIGER BLVD, PORTLAND, OR 97239-2860
(503) 515-7191
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC206937
OR
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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