Active NPI
Michelle K Whittaker, LAC
- Acupuncturist
- Portland, OR
National Provider Identifier
1275767402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC01279
- Practice address
- 315 NE Bryant St
Portland, OR 97211-2903 - Phone
- (954) 612-7118
- NPI assigned
- May 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC01279 | OR | Primary |
Addresses
Primary practice location
315 NE Bryant St
Portland, OR 97211-2903
Mailing address
315 NE Bryant St
Portland, OR 97211-2903
Phone (954) 612-7118
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC01279 | OR | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D'Vida Injury Clinic & Wellness Center LLC | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241136000000",
"number": "1275767402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 NE BRYANT ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972112903",
"telephone_number": "954-612-7118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 NE BRYANT ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972112903",
"telephone_number": "954-612-7118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITTAKER",
"first_name": "MICHELLE",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-01",
"last_updated": "2009-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC01279",
"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 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.