Open Sky Natural Medicine, LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

OPEN SKY NATURAL MEDICINE, LLC

Practice address

1623 SE 6TH Ave
Ste. 200
Portland, OR 97214-3502

Phone

(971) 350-8508

Fax

(971) 275-1552

NPI assigned

Sep 27, 2023

Organization subpart

No

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

Authorized official

Name

Vidhra Jackiw, LACNPI 1154724193

Title

Owner

Phone

(971) 350-8508

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Vidhra Maureen Jackiw, LAC

  • Acupuncturist
  • Portland, OR
  • NPI 1154724193
  NPD Authorized official

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1225817356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 SE 6TH AVE",
            "address_2": "STE. 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143502",
            "telephone_number": "971-350-8508",
            "fax_number": "971-275-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 SE 6TH AVE",
            "address_2": "STE. 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143502",
            "telephone_number": "971-350-8508",
            "fax_number": "971-275-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN SKY NATURAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "JACKIW",
        "authorized_official_first_name": "VIDHRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-350-8508",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500773023",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Mar 18, 2024; 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.