Organization
RED FERN ACUPUNCTURE AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JACOBSEN LAC (ACUPUNCTURIST)
(443) 812-2240
Entity
Organization
Contact information
Practice address
516 SE MORRISON ST, PORTLAND, OR 97214-2327
(443) 812-2240
Mailing address
10500 SE 26TH AVE, APT. G22, MILWAUKIE, OR 97222-9600
(443) 812-2240
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC177271
OR
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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