Provider Demographics
NPI:1871053587
Name:ACUPUNCTURE & WELLNESS NW, PC
Entity type:Organization
Organization Name:ACUPUNCTURE & WELLNESS NW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-810-7547
Mailing Address - Street 1:6664 SW SUSSEX ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5293
Mailing Address - Country:US
Mailing Address - Phone:503-810-7547
Mailing Address - Fax:
Practice Address - Street 1:3857 SW HALL BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2049
Practice Address - Country:US
Practice Address - Phone:503-810-7547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center