Active NPI
Amanda McCracken, L.M.T.
- Other Technician
- Lake Oswego, OR
National Provider Identifier
1124263850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 10973
- Practice address
- 7045 Montauk Cir
Lake Oswego, OR 97035-7828 - Phone
- (503) 470-9161
- NPI assigned
- Dec 9, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 10973 | OR | Primary |
Addresses
Primary practice location
7045 Montauk Cir
Lake Oswego, OR 97035-7828
Mailing address
7045 Montauk Cir
Lake Oswego, OR 97035-7828
Phone (503) 470-9161
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 |
|---|---|---|---|
| 10973 | OR | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228780800000",
"number": "1124263850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7045 MONTAUK CIR",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970357828",
"telephone_number": "503-470-9161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7045 MONTAUK CIR",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970357828",
"telephone_number": "503-470-9161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCRACKEN",
"first_name": "AMANDA",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-09",
"last_updated": "2008-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "OR",
"license": "10973",
"primary": true
}
],
"identifiers": [],
"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 Dec 9, 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.