Active NPI
Jessica Tatieze Temgoua, LAC
- Acupuncturist
- Vancouver, WA
National Provider Identifier
1023319589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC153341
- Practice address
- 4626 NE 93Rd St
Vancouver, WA 98665-5356 - Phone
- (503) 894-2734
- NPI assigned
- Nov 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC153341 | OR | Primary |
Addresses
Primary practice location
4626 NE 93Rd St
Vancouver, WA 98665-5356
Mailing address
4626 NE 93Rd St
Vancouver, WA 98665-5356
Phone (503) 894-2734
Other names 1
- Jessica Heidenreich
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC153341 | OR | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289779200000",
"number": "1023319589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4626 NE 93RD ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986655356",
"telephone_number": "503-894-2734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4626 NE 93RD ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986655356",
"telephone_number": "503-894-2734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATIEZE TEMGOUA",
"first_name": "JESSICA",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-15",
"last_updated": "2010-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC153341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "HEIDENREICH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.