OrganizationTiffany'S Apotheke, LlcAcupuncturistOther Service ProvidersPractice Address1983 NW Flanders St, Suite 109, Portland, OR 97209(503) 705-5738PECOS EnrollmentBased on the most recent information from CMS, provider Tiffany'S Apotheke, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 5:04 PM.Profile DetailsProvider ID1336544725Provider TypeOrganizationFull NameTiffany'S Apotheke, LlcSubpartNoEnumeration Date10/28/2014Last Updated10/28/2014Contact InformationPractice LocationPractice Address1983 NW Flanders St, Suite 109, Portland, OR 97209Phone(503) 705-5738FaxUnlisted FaxMailing LocationMailing Address7333 SE Woodward St, Portland, OR 97206Phone(503) 705-5738FaxUnlisted FaxAuthorized OfficialNamePrado, Tiffany D (Owner)Phone(503) 705-5738Provider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicenseAC156830Oregon