Individual ProviderYedidya TabanpourAcupuncturistOther Service ProvidersPractice Address407 NW 17th Ave # 5, Portland, OR 97209-2247(347) 509-6520PECOS EnrollmentBased on the most recent information from CMS, provider Yedidya Tabanpour 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 ID1346731585Provider TypeIndividualFull NameTabanpour, YedidyaTitleMr.CredentialACUPUNCTURISTGenderMaleSole ProprietorYesEnumeration Date5/23/2018Last Updated9/9/2024Contact InformationPractice LocationPractice Address407 NW 17th Ave # 5, Portland, OR 97209-2247Phone(347) 509-6520Fax(503) 673-2157Mailing LocationMailing Address9118 SW Midea Ct, Portland, OR 97225-2500Phone(347) 509-6520Fax(503) 673-2157Provider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicense187725Oregon