Provider Demographics
NPI:1861791170
Name:THERAPIA P.C.
Entity type:Organization
Organization Name:THERAPIA P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:CRISHANN
Authorized Official - Last Name:NIKZI
Authorized Official - Suffix:
Authorized Official - Credentials:MAC OM, LAC
Authorized Official - Phone:503-317-5700
Mailing Address - Street 1:2505 SW SPRING GARDEN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3966
Mailing Address - Country:US
Mailing Address - Phone:503-841-6222
Mailing Address - Fax:503-841-6199
Practice Address - Street 1:2505 SW SPRING GARDEN ST STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-3966
Practice Address - Country:US
Practice Address - Phone:503-841-6222
Practice Address - Fax:503-841-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
ORAC01146171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty