Provider Demographics
NPI:1386885564
Name:PALAQUIN, LLC.
Entity type:Organization
Organization Name:PALAQUIN, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:5032-246-8004
Mailing Address - Street 1:511 SW 10TH AVE
Mailing Address - Street 2:SUITE 1108
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2732
Mailing Address - Country:US
Mailing Address - Phone:503-224-6800
Mailing Address - Fax:503-222-6049
Practice Address - Street 1:511 SW 10TH AVE
Practice Address - Street 2:SUITE 1108
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2732
Practice Address - Country:US
Practice Address - Phone:503-224-6800
Practice Address - Fax:503-222-6049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty