NPI 1053857482

Ian Wilkinson Lac

Organisation Preferred Provider Organization Portland, OR

Practice location

Address: 4829 NE Martin Luther King Blvd Suite 101, Portland, OR 97211-3491
Phone: (541) 706-1888
Mailing address: 342 NE Morgan St, Portland, OR 97211-2934

Authorised official

Name: Ian James Wilkinson
Title: Acupuncturist
Phone: (541) 706-1888

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence AC179984 (OR)

Other Preferred Provider Organization providers in Oregon →

Registry record

NPI: 1053857482
Entity type: Organization
NPI issued: 9 Jan 2017
Record last updated: 9 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.