Organization · NPI-2

Dancing Aspen Healing Arts LLC

Acupuncturist · Gresham, OR

NPI number1902591357
StatusActive
Last updated in NPPESFeb 6, 2024

Details

NPI
1902591357
Entity type
Organization (NPI-2)
Legal business name
Dancing Aspen Healing Arts LLC
Organization subpart
No
Enumeration date
Apr 10, 2023
Certification date
Feb 6, 2024
Last updated
Feb 6, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171100000X Acupuncturist––Yes

Practice location

22400 Se Stark St Ste 106
Gresham, OR 97030-2656

Phone 503-913-2136 · Fax 503-825-0137

Mailing address

333 Nw Wallula Ave
Gresham, OR 97030-5410

Phone 503-913-2136

Authorized official

Caitlynn Claire Didlick Bohman
Business Owner / Acupuncturist
5039132136

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