Provider Demographics
NPI:1063728442
Name:SLOAN, ALEXIA HONORE (LAC)
Entity type:Individual
Prefix:MS
First Name:ALEXIA
Middle Name:HONORE
Last Name:SLOAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7635 N DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-5009
Mailing Address - Country:US
Mailing Address - Phone:503-784-7081
Mailing Address - Fax:
Practice Address - Street 1:8315 N DENVER AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-6707
Practice Address - Country:US
Practice Address - Phone:503-285-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01283171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist