Katherine Kualaau | Portland, OR • PECOS Search

Katherine Kualaau

Acupuncturist

Other Service Providers

1308 NW 20th Ave Ste 10, Portland, OR 97209-1607

PECOS Enrollment

Based on the most recent information from CMS, provider Katherine Kualaau does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1043789472
Provider Type
Individual
Full Name
Kualaau, Katherine
Credential
LAC, MACOM

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/14/2018
Last Updated
11/14/2018

Contact Information

Practice Location

1308 NW 20th Ave Ste 10, Portland, OR 97209-1607

Unlisted Fax

Mailing Location

1308 NW 20th Ave Ste 10, Portland, OR 97209-1607

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171100000X Primary	Description Acupuncturist Other Service Providers	License AC190006 Oregon