Borba Spann, Kacy Leann
Borba Spann, Kacy Leann is an sole proprietor health care provider with primary practice located at 3942 Se Hawthorne Blvd , Portland OR 97214-5242. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Acupuncturist, Other Service Providers / Specialist, Other Service Providers / Naturopath. Other Service Providers / Naturopath is her primary health care specialty. Borba Spann, Kacy Leann can be contacted via phone (712) 581-8539.Contact Information
Primary practice address
3942 Se Hawthorne Blvd
Portland OR 97214-5242
Phone: (712) 581-8539
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Acupuncturist | 171100000X | AC167588 | Oregon |
| Other Service Providers / Specialist | 174400000X | 20290 | Oregon |
| Other Service Providers / Naturopath | 175F00000X | 2022 | Oregon |
Profile Details
| NPI number | 1649699455 |
|---|---|
| LBN Legal business name | Borba Spann, Kacy Leann |
| Credentials | N.D., LAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 8th, 2014 |
| Last updated | Jan 28th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649699455 | NPPES |
| Oregon | MEDICAID | 500688613 | |
| Oregon | MEDICAID | 500680362 |
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