Provider Demographics
NPI:1720896731
Name:HITCHCOCK, DARCY ELIZABETH (LAC)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:ELIZABETH
Last Name:HITCHCOCK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:DARCY
Other - Middle Name:ELIZABETH
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9725 NE CAMPAIGN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-3529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9725 NE CAMPAIGN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-3529
Practice Address - Country:US
Practice Address - Phone:419-203-1452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC222290171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist