Individual
MICHAEL GARY RICCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
11750 SW BARNES RD STE 240, PORTLAND, OR 97225-5911
(503) 389-6962
Mailing address
804 SE 30TH AVE, PORTLAND, OR 97214-4008
(503) 407-7062
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC200078
OR
Other
Enumeration date
11/01/2020
Last updated
11/01/2020
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