Jacqueline Eliesa Stivers, ND LAC

Primary specialty

NaturopathTaxonomy code 175F00000X

License

4216 Issued in OR

Practice address

2318 NE MLK Jr Blvd
Portland, OR 97212-3715

Phone

(503) 335-8611

NPI assigned

Oct 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacqueline.stivers.p1@direct.voaor.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Volunteers of America Inc.

  • Contractor
  • Portland, OR
  • NPI 1376611418

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1205301975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123715",
            "telephone_number": "503-539-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2318 NE MLK JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123715",
            "telephone_number": "503-335-8611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 SE 11th Ave Ste 226",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97214",
            "country_code": "US",
            "telephone_number": "971-279-4454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIVERS",
        "first_name": "JACQUELINE",
        "middle_name": "ELIESA",
        "name_prefix": "Dr.",
        "credential": "ND LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC190894",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "OR",
            "license": "4216",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desirae Nicole Stites, M.A.
• James Matlock Stites, D.C.
• Mary Theresa Stites, LMFT
• Brett Stithem, LCSW
• Lisa Mae Stitt
• Sarah M Stivers, L.M.T.
• Eric Lee Stiverson, PHARMD
• Lidija Stjepanovic, FNP-C
• Michelle Stobbe, LAC
• Alexander M Stock, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.