Clear Heart Acupuncture, LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC175542 Issued in OR

Legal business name

CLEAR HEART ACUPUNCTURE, LLC

Practice address

4605 NE Fremont St Ste 103
Portland, OR 97213-1708

Phone

(503) 395-5228

Fax

(844) 814-4767

NPI assigned

Mar 1, 2016

Last updated

Mar 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Baucum, LACNPI 1104284736

Title

Owner

Phone

(503) 395-5228

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Lynn Baucum, LAC

  • Acupuncturist
  • Portland, OR
  • NPI 1104284736
  NPD (past) Authorized official

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1346600582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86371",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972860371",
            "telephone_number": "503-395-5228",
            "fax_number": "844-814-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 NE FREMONT ST STE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131708",
            "telephone_number": "503-395-5228",
            "fax_number": "844-814-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR HEART ACUPUNCTURE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "BAUCUM",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-395-5228",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC175542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Clayton, MD
• Robin Clayton
• Sally Victoria Clayton, PH.D.
• Cleanse Wellness Company
• Cleanse Wellness Company LLC
• Clear Heart, LLC (Clear Heart Counseling)
• Clear Path Behavioral Health and Wellness Services LLC
• Clear Path Counseling, LLC
• Clear Path Medical Transportation LLC
• Clear Path Treatment Services, LLC

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.