Provider Type Icon

MOUNTAIN LAKE WELLNESS LLC NPI 1841545092


NPI Information

NPI: 1841545092
Provider Name: MOUNTAIN LAKE WELLNESS LLC
Classification: Acupuncturist - 171100000X
Entity Type: Organization
Address:
2442 SE 101ST AVE
SUITE 308
PORTLAND, OR
ZIP 97216
Phone: (503) 828-3050
Get Directions

MOUNTAIN LAKE WELLNESS LLC is an acupuncturist in Portland, OR. The provider is an acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia. MOUNTAIN LAKE WELLNESS LLC NPI is 1841545092. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2442 SE 101ST AVE
SUITE 308
PORTLAND, OR
ZIP 97216-060
Phone: (503) 828-3050

The provider's authorized official is Leslie Huddart .
The authorized official title is Owner and has the following contact phone number (503) 828-3050.

The enumeration date for this NPI number is 7/13/2012 and was last updated on 7/13/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1171100000XAcupuncturistAC153196OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.