Audrey Rock Moss, L.AC., LMT

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC01141 Issued in OR

Practice address

5667 NE Glisan St
Portland, OR 97213-3747

Phone

(503) 481-4615

Fax

(503) 233-8415

NPI assigned

May 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1164699401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 SE 82ND AVE",
            "address_2": "STE 1000 - 145",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662924",
            "telephone_number": "503-481-4615",
            "fax_number": "503-233-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133747",
            "telephone_number": "503-481-4615",
            "fax_number": "503-233-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "AUDREY",
        "middle_name": "ROCK",
        "name_prefix": "Ms.",
        "credential": "L.AC., LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01141",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "8563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Lee Mosley III, DMD
• Erika Mosqueda Franco
• Lorena Mosqueda
• Moss and Moon Bodywork
• Abby Marie Moss
• Benjamin Moss, MD
• Jacob Russell Moss
• Jennifer Melissa Moss, MFT
• Josha Moss, PTA
• Kelsey-Jo Audrey Moss, CPNP-PC

• 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 May 15, 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.

Verify at the official NPI Registry.