Individual provider Active NPI

Desiree Michelle Serrano, LAC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1295625689
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC226315 Issued in OR
Practice address
4927 NE 30TH Ave
Portland, OR 97211-7007
Phone
(503) 281-0681
NPI assigned
Jul 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC226315 OR Primary

Addresses

Primary practice location

4927 NE 30TH Ave
Portland, OR 97211-7007

Mailing address

3810 SE Division St Apt 201
Portland, OR 97202-1689
Phone (619) 804-5994

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
AC226315ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Oldendorf PastSince Jul 13, 2025 Accepting new patients
Michelle Reynolds Acupuncturist PastSince Jul 13, 2025 Accepting new patients

Organizations & group practices 2

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": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1295625689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 SE DIVISION ST APT 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021689",
            "telephone_number": "619-804-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4927 NE 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972117007",
            "telephone_number": "503-281-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "DESIREE",
        "middle_name": "MICHELLE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC226315",
            "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 7, 2025; 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.