Individual
ELIZABETH SPAGAT WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND,LAC
Contact information
Practice address
2024 SE CLINTON ST., PORTLAND, OR 97202
(503) 242-1212
(503) 236-7637
Mailing address
2024 SE CLINTON ST., PORTLAND, OR 97202
(503) 242-1212
(503) 236-7637
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
0020610
OR
175F00000X
Naturopath
Primary
1283
OR
Other
Enumeration date
04/03/2007
Last updated
04/28/2017
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