Trista L. Jolly MAOM, L.AC.

NPI 1952589129 - Acupuncturist - 171100000X

NPI Details
NPI 1952589129
Gender Female
Enumeration Date 02/09/2008
Last Updated 02/09/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
PORTLAND OR, 97232-1981, US
Phone (503) 703-3197
Business Location
1142 SE 52ND AVE
PORTLAND OR, 97215-2633, US
Phone (503) 703-3197
Taxonomy Code 171100000X
License State Oregon
License Number AC01171
Remove 1952589129 NPI Number

According to our database, Trista L. Jolly MAOM, L.AC. NPI is 1952589129, taxonomy code is 171100000X and license number is AC01171, license state is located at Oregon. Trista L. Jolly MAOM, L.AC. physically located at 3234 Ne Wasco St, Portland OR, 97232-1981. NPI Number Trista L. Jolly MAOM, L.AC. has the Individual type.

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1952589129 NPI number is provided on an as is basis without warranty of any kind. 1952589129 is maintained by the National Plan & Provider Enumeration System. The contents of Trista L. Jolly MAOM, L.AC. are for informational purposes only.