Basic Information
| Provider Information | |||||||||
| NPI: | 1770221210 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GINGER PEAR ACUPUNCTURE AND MASSAGE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2020 TOMPKINS ST | ||||||||
| Address2: | |||||||||
| City: | WEST LINN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970682778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033482265 | ||||||||
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| Practice Location | |||||||||
| Address1: | 18807 WILLAMETTE DR | ||||||||
| Address2: | |||||||||
| City: | WEST LINN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970681711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033482265 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2022 | ||||||||
| LastUpdateDate: | 05/24/2022 | ||||||||
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| AuthorizedOfficialLastName: | CYPHERS | ||||||||
| AuthorizedOfficialFirstName: | ROBIN | ||||||||
| AuthorizedOfficialMiddleName: | ELIZABETH | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5033482265 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LAC, LMT | ||||||||
| NPICertificationDate: | 05/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | 171100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Acupuncturist |
No ID Information.