Jenna Mandzuk, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC165564 Issued in OR

Practice address

20508 SW Roy Rogers Rd Ste 145
Sherwood, OR 97140-9931

Phone

(971) 340-0073

NPI assigned

Feb 28, 2014

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

State licenses

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

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1104241025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20845 SW EDY RD",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971408616",
            "telephone_number": "971-340-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20508 SW ROY ROGERS RD STE 145",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409931",
            "telephone_number": "971-340-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDZUK",
        "first_name": "JENNA",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-28",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC165564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily E Luis, D.P.T.
• Leatha Lorine Lynch, RPH, PHARMD
• Douglas Lytz
• Makenzie Maurice
• Nisreen Malik
• Deborah A Marinos
• Katlyn Marquess, LAC
• Bridget C Martin, MD
• Trevor Martin, DMD
• Makenzie Maurice, LMT

• Acupuncturist in Sherwood, OR
• Providers in Sherwood, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.