Provider Demographics
NPI:1679747661
Name:HEALING TOUCH ACUPUNCTURE CLINIC, P.C.
Entity type:Organization
Organization Name:HEALING TOUCH ACUPUNCTURE CLINIC, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERRI
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:GALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LPC
Authorized Official - Phone:503-452-0224
Mailing Address - Street 1:1509 SW SUNSET BLVD STE 1F
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-2689
Mailing Address - Country:US
Mailing Address - Phone:503-452-0224
Mailing Address - Fax:
Practice Address - Street 1:1509 SW SUNSET BLVD STE 1F
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2689
Practice Address - Country:US
Practice Address - Phone:503-452-0224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00764171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty