Antara Acupuncture and Herbal Clinic LLC

NPI #1356692115 in Gresham, Oregon

Provider Information

NPI Number: 1356692115
Entity Type: Organization
Organization Name: Antara Acupuncture and Herbal Clinic LLC
Primary Specialty: Acupuncturist
Enumeration Date: Sep 19, 2012
Last Updated: Sep 19, 2012

Practice Location

Address: 130 NW MILLER AVE
City: Gresham
State: Oregon
ZIP Code: 97030-7226
Phone: (503) 665-2344

Authorized Official

Name: KATELYN DECKER, L.AC., M.AC.O.M.
Title: OWNER/LICENSED ACUPUNCTURIST
Phone: (971) 235-1171

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X	Primary

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