Individual provider Active NPI

Jennifer K Reyna, L.AC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1275056103
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC184488 Issued in OR
Practice address
2232 NW Pettygrove St Ste 100
Portland, OR 97210-2372
Phone
(971) 238-2435
NPI assigned
Jul 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X AC184488 OR Primary

Addresses

Primary practice location

2232 NW Pettygrove St Ste 100
Portland, OR 97210-2372

Mailing address

2232 NW Pettygrove St Ste 100
Portland, OR 97210-2372
Phone (971) 238-2435

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
AC184488ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275056103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 NW PETTYGROVE ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102372",
            "telephone_number": "971-238-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 NW PETTYGROVE ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102372",
            "telephone_number": "971-238-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNA",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC184488",
            "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 Jul 21, 2022; 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.