Lori Jenette Goerlitz, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC00001894 Issued in WA

Practice address

5825 221St PL SE Ste 206
Issaquah, WA 98027-8927

Phone

(425) 765-5005

Fax

(425) 392-8338

NPI assigned

Jan 28, 2008

Last updated

Jan 28, 2008By 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

Other names 1

• Lori Jenette Caldwell Former name

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.

• Squak Mountain Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Issaquah, WA
  • NPI 1497936892
  NPD (past)

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1063699445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 243RD AVE SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296500",
            "telephone_number": "425-765-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 221ST PL SE STE 206",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278927",
            "telephone_number": "425-765-5005",
            "fax_number": "425-392-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOERLITZ",
        "first_name": "LORI",
        "middle_name": "JENETTE",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00001894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "CALDWELL",
            "middle_name": "JENETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marsha Gilluly
• Leslie Giron, LMP
• Glenn J Yorita DDS, Ms
• Robert Jay Glowitz, MD
• Mukti V Godbole, OTR/L, CHT
• Neda Goharkhay, DDS
• Kristi Lynn Goings, CPNP
• Hengameh Golchin, PHARMD
• Leah Goldberg, LMP
• Sophia Evelyn Mimi Goldberg

• Acupuncturist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Acupuncturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.