Active NPI
Yoshifumi Ito, LICENSED ACUPUNCTURI
- Acupuncturist
- Tigard, OR
National Provider Identifier
1104984004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC00734
- Practice address
- 12566 SW Main St.
Tigard, OR 97223 - Phone
- (503) 490-2326
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC00734 | OR | Primary |
Addresses
Primary practice location
12566 SW Main St.
Tigard, OR 97223
Mailing address
15547 SW Black Quartz St.
Beaverton, OR 97007
Phone (503) 490-2326
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC00734 | OR | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1104984004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15547 SW BLACK QUARTZ ST.",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97007",
"telephone_number": "503-490-2326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12566 SW MAIN ST.",
"city": "TIGARD",
"state": "OR",
"postal_code": "97223",
"telephone_number": "503-490-2326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITO",
"first_name": "YOSHIFUMI",
"name_prefix": "Mr.",
"credential": "LICENSED ACUPUNCTURI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC00734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.