Provider Demographics
NPI:1871738682
Name:HEALING RESPONSE ACUPUNCTURE & INTEGRATIVE MEDICINE
Entity type:Organization
Organization Name:HEALING RESPONSE ACUPUNCTURE & INTEGRATIVE MEDICINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE - OFFICE SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:TIINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-410-6107
Mailing Address - Street 1:11550 STILLWATER BLVD N STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-8613
Mailing Address - Country:US
Mailing Address - Phone:651-323-0005
Mailing Address - Fax:651-927-0099
Practice Address - Street 1:11550 STILLWATER BLVD N STE 101
Practice Address - Street 2:
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-8613
Practice Address - Country:US
Practice Address - Phone:651-323-0005
Practice Address - Fax:651-927-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01012171100000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty