Individual provider Active NPI

Anna Brook, L. AC.

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1023224532
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00587 Issued in OR
Practice address
3125 NE Holladay St
Portland, OR 97232-2504
Phone
(503) 515-5316
Fax
(503) 235-3768
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00587 OR Primary

Addresses

Primary practice location

3125 NE Holladay St
Portland, OR 97232-2504

Mailing address

1021 NE 33Rd Ave
Portland, OR 97232-2518
Phone (503) 515-5316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC00587ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023224532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 NE 33RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322518",
            "telephone_number": "503-515-5316",
            "fax_number": "503-235-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 NE HOLLADAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322504",
            "telephone_number": "503-515-5316",
            "fax_number": "503-235-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOK",
        "first_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "L. AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.