Individual
MICHELLE GAULKE BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
24850 SE STARK ST SUITE 200, GRESHAM, OR 97030-2656
(503) 665-9355
(503) 661-3430
Mailing address
24850 SE STARK ST STE 200, GRESHAM, OR 97030-8320
(503) 665-9355
(503) 661-3430
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00567
OR
Other
Enumeration date
10/31/2006
Last updated
04/19/2017
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