Amanda Lyn Bunker, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC211822 Issued in OR

Practice address

12778 SE Stark St Unit 125
Portland, OR 97233-1539

Phone

(503) 317-3113

NPI assigned

Aug 8, 2023

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

Other names 1

• Mandalyn Bunker Other name

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1124701933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12778 SE STARK ST UNIT 125",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "503-317-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12778 SE STARK ST UNIT 125",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "503-317-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNKER",
        "first_name": "AMANDA",
        "middle_name": "LYN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC211822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDALYN",
            "last_name": "BUNKER",
            "credential": "LAC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amelia Renee Bunch, BA
• April Bunch, LPC ASSOCIATE
• Marilyn Bunch
• Shauri Bunch, LPC
• Michelle Jeanne Buncke
• Colleen R. Bunker, LAC
• Matthew Alexander Bunker, PA-C
• Theresa Bunker, FNP
• Samajean S Bunn, CADC I
• Steven M. Bunnage, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.