NPIMap

Organization Active NPI

Jeremy Jacks Lac LLC

Doing business as Meridian Acupuncture and Wellness

  • Acupuncturist
  • Tigard, OR
National Provider Identifier
1356102347
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
JEREMY JACKS LAC LLC
Doing business as
Meridian Acupuncture and Wellness
Practice address
6750 SW Franklin St Ste B
Tigard, OR 97223-2520
Phone
(503) 692-9680
Fax
(503) 670-4954
NPI assigned
Jan 17, 2024
Last updated
Jan 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
Mr. Jeremy A. Jacks, L.AC.NPI 1184697344
Title
Owner
Phone
(503) 692-9680

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X Primary

Addresses

Primary practice location

6750 SW Franklin St Ste B
Tigard, OR 97223-2520

Mailing address

6750 SW Franklin St Ste B
Tigard, OR 97223-2520
Phone (503) 692-9680

Other names 1

  • Meridian Acupuncture and Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

6750 SW Franklin St
Tigard, OR 97223

6750 SW Franklin St
Ste B
Tigard, OR 97223
Phone (503) 692-9680

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1356102347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 SW FRANKLIN ST STE B",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232520",
            "telephone_number": "503-692-9680",
            "fax_number": "503-670-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 SW FRANKLIN ST STE B",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232520",
            "telephone_number": "503-692-9680",
            "fax_number": "503-670-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY JACKS LAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "JACKS",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-692-9680",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Acupuncture and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.