Emma Ellsworth, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC196567 Issued in OR

Practice address

12778 SE Stark St # 125
Portland, OR 97233-1539

Phone

(503) 317-3113

NPI assigned

Mar 8, 2020

Last updated

Mar 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inner Gate Acupuncture LLC

  dba Inner Gate Health & Wellness

  • Acupuncturist
  • Portland, OR
  • NPI 1306019310
  NPD (past)
• Wintzer Acupuncture LLC

  • Acupuncturist
  • Camas, WA
  • NPI 1770855777
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1013542208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 NW NORTH RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972292593",
            "telephone_number": "804-878-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12778 SE STARK ST # 125",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "503-317-3113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1421 SE Ankeny St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972141471",
            "country_code": "US",
            "telephone_number": "503-284-6996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6230 NE Halsey St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972134718",
            "country_code": "US",
            "telephone_number": "971-279-2294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "EMMA",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-08",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC196567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Marie Ellison, MD
• David Hoadley Ellison, MD
• John Michael Ellison, FNP
• Lindsey W Ellison, PHARMD
• Alissa Claire Ellsworth, CSWA
• Sheilla Treacy Ellsworth, PHYSICAL THERAPIST
• Sherri Lee Ellsworth
• Nadja Printup Jones Elm
• Lily Elmer
• Abdisattar Hassan Elmi, QMHA

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.