Individual provider Active NPI

Emery Olson, LAC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1306470760
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC195752 Issued in OR
Practice address
4410 SW Beaverton Hillsdale Hwy
Portland, OR 97221-3660
Phone
(503) 244-7525
NPI assigned
Feb 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC195752 OR Primary

Addresses

Primary practice location

4410 SW Beaverton Hillsdale Hwy
Portland, OR 97221-3660

Mailing address

8925 SW 40TH Ave
Portland, OR 97219-3630

Other practice location 1

1030 NE Couch St
Portland, OR 97232-3067
Phone (855) 733-2632

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
AC195752ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1306470760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8925 SW 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 SW BEAVERTON HILLSDALE HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972213660",
            "telephone_number": "503-244-7525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 NE Couch St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972323067",
            "country_code": "US",
            "telephone_number": "855-733-2632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "EMERY",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-25",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC195752",
            "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 Apr 6, 2023; 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.