Organization
MANDALA MEDICINE ACUPUNCTURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA RIEDMAN LAC (OWNER)
(503) 758-9760
Entity
Organization
Contact information
Practice address
3125 E BURNSIDE ST, PORTLAND, OR 97214-2073
(503) 758-9760
Mailing address
1020 SE 7TH AVE #14100, PORTLAND, OR 97293
(503) 758-9760
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 152885
OR
225100000X
Physical Therapist
—
OR
Other
Enumeration date
03/26/2011
Last updated
03/16/2016
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