NPIMap

Organization Active NPI

Mississippi Health Center Medicinay LLC

  • Naturopath
  • Portland, OR
National Provider Identifier
1174747943
Registry record updated Apr 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
1400 Issued in OR
Legal business name
MISSISSIPPI HEALTH CENTER MEDICINAY LLC
Practice address
4631 N Albina Ave
Portland, OR 97217-3011
Phone
(503) 282-5358
Fax
(503) 735-3777
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2008

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

Authorized official

Name
Beth Yohalem-Ilsley, L.AC.NPI 1215154372
Title
Co-President
Phone
(503) 267-1565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC00668 OR
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X 1400 OR Primary

Addresses

Primary practice location

4631 N Albina Ave
Portland, OR 97217-3011

Mailing address

4631 N Albina Ave
Portland, OR 97217-3011
Phone (503) 282-5358

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208736000000",
    "number": "1174747943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 N ALBINA AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173011",
            "telephone_number": "503-282-5358",
            "fax_number": "503-735-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 N ALBINA AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173011",
            "telephone_number": "503-282-5358",
            "fax_number": "503-735-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI HEALTH CENTER MEDICINAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-04-21",
        "status": "A",
        "authorized_official_last_name": "YOHALEM-ILSLEY",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "503-267-1565",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00668",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1400",
            "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 Apr 21, 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.