Provider Demographics
NPI:1174994867
Name:GAZZINI, PATRICK (LAC)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:GAZZINI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5295 NE ELAM YOUNG PKWY STE 160
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7573
Mailing Address - Country:US
Mailing Address - Phone:503-844-4325
Mailing Address - Fax:503-400-7984
Practice Address - Street 1:5035 NE ELAM YOUNG PKWY STE 500
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6473
Practice Address - Country:US
Practice Address - Phone:503-844-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC174799171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist