Organization Active NPI

Westlake Integrative Medicine LLC

  • Acupuncturist
  • Lake Oswego, OR
National Provider Identifier
1073302204
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
WESTLAKE INTEGRATIVE MEDICINE LLC
Practice address
14535 Westlake Dr Ste B
Lake Oswego, OR 97035-7775
Phone
(503) 479-5608
NPI assigned
May 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Authorized official

Name
Dr. Paul Yutan, MDNPI 1114963196
Title
Medical Doctor
Phone
(503) 479-5608

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X Primary

Addresses

Primary practice location

14535 Westlake Dr Ste B
Lake Oswego, OR 97035-7775

Mailing address

14110 Gabrielle CT
Lake Oswego, OR 97035-5759
Phone (503) 314-7889

Other identifiers 1

IdentifierTypeStateIssuer
1114963196OtherTYPE 1 NPI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1073302204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14110 GABRIELLE CT",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355759",
            "telephone_number": "503-314-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14535 WESTLAKE DR STE B",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357775",
            "telephone_number": "503-479-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTLAKE INTEGRATIVE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-04",
        "status": "A",
        "authorized_official_last_name": "YUTAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "503-479-5608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1114963196",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.