Derek Arthur Henderlong, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC180963 Issued in OR

Practice address

36200 Pittsburg Rd
Saint Helens, OR 97051-1188

Phone

(503) 397-1505

NPI assigned

Nov 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1275046922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 NE FLANDERS ST APT 312",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323193",
            "telephone_number": "503-380-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36200 PITTSBURG RD",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970511188",
            "telephone_number": "503-397-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERLONG",
        "first_name": "DEREK",
        "middle_name": "ARTHUR",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC180963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Saint Helens, OR
• Providers in Saint Helens, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.