Zocalo Wellness, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

AC156050 Issued in OR

Legal business name

ZOCALO WELLNESS, LLC

Practice address

2100 NE Broadway St Ste 225
Portland, OR 97232-1544

Phone

(503) 724-4321

Fax

(971) 255-1754

NPI assigned

Nov 24, 2015

Organization subpart

No

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

Authorized official

Name

Adrianna Nichole Locke, L.AC

Title

Owner

Phone

(503) 724-4321

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1336513662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321544",
            "telephone_number": "503-724-4321",
            "fax_number": "971-255-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321544",
            "telephone_number": "503-724-4321",
            "fax_number": "971-255-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZOCALO WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "ADRIANNA",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-724-4321",
        "authorized_official_credential": "L.AC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "AC156050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500639308",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonio Zitting, MS, QMHP-R
• Olga I Zlatova I, RDH
• Lauren Renee Zlott, M.A.
• Amy Zmick
• Erica R. Zobel, QMHP, MOTR/L
• Linsey Elaine Zocco, PA-C
• Katherine Zochowski
• Keely Bittersweet Zodrow-Novak, DPT
• Garrett Keith Zoeller, M.D.
• Kennda Zoffka, PHARMD

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.