Individual provider Active NPI

Regan Goodrich, LAC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1104273986
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC184718 Issued in OR
Practice address
2705 E Burnside St Ste 102
Portland, OR 97214
Phone
(541) 350-9437
NPI assigned
May 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC184718 OR Primary

Addresses

Primary practice location

2705 E Burnside St Ste 102
Portland, OR 97214

Mailing address

8006 N Wabash Ave
Portland, OR 97217-6040
Phone (541) 350-9437

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

LicenseStateTypeSpecialty
AC184718ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Seed Acupuncture and Massage Acupuncturist CurrentSince Jul 23, 2023 Accepting new patients

Locations

2705 E Burnside St
Ste 102
Portland, OR 97214
Phone (503) 752-9943

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1104273986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8006 N WABASH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972176040",
            "telephone_number": "541-350-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 E BURNSIDE ST STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "541-350-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "REGAN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC184718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.