Bethe Ann Mack, LMT

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

11341 Issued in OR

Practice address

2625 SE Hawthorne Blvd
Portland, OR 97214-2941

Phone

(503) 238-9788

NPI assigned

Mar 23, 2007

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

Practice roles

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

• Dr Surah Hirsch DC & Assoc PC

  • Chiropractor
  • Portland, OR
  • NPI 1467628735
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033236922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 NE 74TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97218",
            "telephone_number": "503-481-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142941",
            "telephone_number": "503-238-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "BETHE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OR",
            "license": "11341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Maciejewski
• Luis Manuel Maciel Santacruz
• Natasha A Macilveen, PT, DPT
• Izabela Maciolek, PA-C
• Annie Seapan Mack, MD
• Joel David Mack, M.D.
• Olivia Araby Mack
• Heather Mackay, M.ED. M.A.
• Ian Mackay
• John Edward Mackay, PHARM.D., BCPS

• Health Maintenance Organization in Portland, OR
• Providers in Portland, OR by specialty
• Health Maintenance Organization in Oregon

• 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.