Provider Demographics
NPI:1285247726
Name:HAN, ALEINA (LAC)
Entity type:Individual
Prefix:
First Name:ALEINA
Middle Name:
Last Name:HAN
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 1:1020 SW TAYLOR ST STE 340
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2508
Mailing Address - Country:US
Mailing Address - Phone:503-714-8924
Mailing Address - Fax:503-714-8924
Practice Address - Street 1:1020 SW TAYLOR ST STE 340
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2508
Practice Address - Country:US
Practice Address - Phone:503-714-8924
Practice Address - Fax:503-714-8924
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC200991171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty