Individual provider Active NPI

Vickie Del-Rae Golab, L.AC.

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1285764084
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00251 Issued in OR
Practice address
4475 SW Scholls Ferry Rd
Suite 210
Portland, OR 97225-1955
Phone
(503) 245-2272
Fax
(503) 292-0786
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00251 OR Primary

Addresses

Primary practice location

4475 SW Scholls Ferry Rd
Suite 210
Portland, OR 97225-1955

Mailing address

4475 SW Scholls Ferry Rd
Suite 210
Portland, OR 97225-1955
Phone (503) 245-2272

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
AC00251ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Center of Raleigh Hills PC PastSince Nov 20, 2018 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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285764084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD",
            "address_2": "SUITE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251955",
            "telephone_number": "503-245-2272",
            "fax_number": "503-292-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD",
            "address_2": "SUITE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251955",
            "telephone_number": "503-245-2272",
            "fax_number": "503-292-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLAB",
        "first_name": "VICKIE",
        "middle_name": "DEL-RAE",
        "name_prefix": "Ms.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00251",
            "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 8, 2007; 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.