Balance Health & Injury Clinic, PC
Organization Active NPI Acupuncturist · Gresham, OR
NPI 1013289735 · NPPES record last updated Aug 15, 2022
Key facts
- NPI
- 1013289735
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Acupuncturist 171100000X
- License
- AC00635 (OR)
- Legal business name
- BALANCE HEALTH & INJURY CLINIC, PC
- Practice address
- 1217 NE Burnside Rd Ste 301
Gresham, OR 97030-5705 - Phone
- (503) 492-2625
- Fax
- (503) 492-2355
- NPI assigned
- Jan 27, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Daniel Leonard Desjardins, DC
- Title
- Chiropractor
- Phone
- (503) 492-2625
Practitioners 12
-
Eric Strand, LAC, DAC, PHD
-
Holly A Barnett, LMT
-
Brooke Braga, LMT
-
Brittany Courtney, LMT
-
Christina Lambert, L.AC.
-
Ross McCallum, LAC
-
Tiffany Dawn Prado, DACM, L.AC.
-
Jessica L Ulmer, LMT
-
Erik Wold, LMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150623001747 | OR | Part B Supplier - Clinic/Group Practice | 5294046835 |
Receives reassigned benefits from 1 practitioner Practice locations: Gresham, OR |
National Provider Directory
Locations
1217 NE Burnside Rd
Ste 301
Gresham, OR 97030
Phone (503) 492-2625
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 3243 | OR | |
| Acupuncturist |
171100000X | AC00635 | OR | Yes |
Addresses
Primary practice location
1217 NE Burnside Rd Ste 301
Gresham, OR 97030-5705
Mailing address
1217 NE Burnside Rd
Suite 301
Gresham, OR 97030-5705
Phone (503) 492-2625
Other names
- Balance
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.