Shahrzad Vossoughi Fakhravar | Portland, OR • PECOS Search

Shahrzad Vossoughi Fakhravar

Acupuncturist

Other Service Providers

1125 NW 9th Ave, Suite 107b, Portland, OR 97209-2864

PECOS Enrollment

Based on the most recent information from CMS, provider Shahrzad Vossoughi Fakhravar 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 yesterday at 5:04 PM.

Profile Details

Provider ID
1356644579
Provider Type
Individual
Full Name
Fakhravar, Shahrzad Vossoughi
Credential
L.AC.

Gender
Female
Sole Proprietor
No
Enumeration Date
12/9/2010
Last Updated
12/9/2010

Contact Information

Practice Location

1125 NW 9th Ave, Suite 107b, Portland, OR 97209-2864

Unlisted Fax

Mailing Location

3458 SW Doschview Ct, Portland, OR 97239-1487

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171100000X Primary	Description Acupuncturist Other Service Providers	License AC152813 Oregon