Ancient Fern Medicine

NPI #1053763466 in Portland, Oregon

Provider Information

NPI Number: 1053763466
Entity Type: Organization
Organization Name: Ancient Fern Medicine
Primary Specialty: Acupuncturist
Enumeration Date: Jul 8, 2016
Last Updated: Jul 8, 2016

Practice Location

Address: 2926 NE FLANDERS ST STE 2C
City: Portland
State: Oregon
ZIP Code: 97232-3259
Phone: (971) 227-2773

Authorized Official

Name: TIMOTHY NICHOLAS NELSON, L.AC.
Title: OWNER
Phone: (971) 227-2773

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X	Primary

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