Shawn P. Kinsella, LAC, LMT

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC202894 Issued in OR

Practice address

3605 SE 26TH Ave
Portland, OR 97202-2953

Phone

(503) 234-0325

NPI assigned

Feb 8, 2011

Sex

Male

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

Practice roles

Locations

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.

• Metta River LLC

  • Acupuncturist
  • Portland, OR
  • NPI 1740997485
  NPD Authorized official

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1265738272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3743 SE CORA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023237",
            "telephone_number": "310-488-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 SE 26TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022953",
            "telephone_number": "503-234-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "SHAWN",
        "middle_name": "P.",
        "credential": "LAC, LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-08",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17765",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC202894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hollis Benjamin Kinner IV, CSWA, LMSW
• Erin Marie Kinney
• Patrick Kinney, RN
• Sarah K Kinnie, RT
• Michelle Ann Kinsella, OT
• Damon Kinser
• Jessica Kinser, MSHI, RN, PHN, CIC
• Katherine A Kinser, PA-C
• Kinship House
• Kinship House

• 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 Jul 16, 2021; 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.