Individual provider Active NPI

Laurie Menk Otto, ND

  • Naturopath
  • Portland, OR
National Provider Identifier
1215347505
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
1825 Issued in OR
Practice address
2612 SE 75TH Ave
Portland, OR 97206-1006
Phone
(503) 358-6986
NPI assigned
May 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 1825 OR Primary

Addresses

Primary practice location

2612 SE 75TH Ave
Portland, OR 97206-1006

Mailing address

2612 SE 75TH Ave
Portland, OR 97206-1006
Phone (503) 358-6986

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

LicenseStateTypeSpecialty
1825ORMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1215347505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 SE 75TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061006",
            "telephone_number": "503-358-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 SE 75TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061006",
            "telephone_number": "503-358-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENK OTTO",
        "first_name": "LAURIE",
        "credential": "ND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1825",
            "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 May 7, 2014; 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.