Provider Demographics
NPI:1215330402
Name:MALINDA FINNELL L.AC
Entity type:Organization
Organization Name:MALINDA FINNELL L.AC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MALINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-867-5885
Mailing Address - Street 1:10840 SW 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-7551
Mailing Address - Country:US
Mailing Address - Phone:503-867-5885
Mailing Address - Fax:
Practice Address - Street 1:1820 SW VERMONT ST STE D
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1945
Practice Address - Country:US
Practice Address - Phone:503-867-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC169061171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty