Organization Active NPI

Keivan Jinnah, ND, Lac, PC

  • Naturopath
  • Portland, OR
National Provider Identifier
1366586703
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
0972 Issued in OR
Legal business name
KEIVAN JINNAH, ND, LAC, PC
Practice address
3007 SE Belmont St
Portland, OR 97214-4026
Phone
(503) 445-7115
Fax
(503) 445-7116
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Authorized official

Name
Dr. Keivan A. Jinnah, ND, LAC.
Title
President
Phone
(503) 445-7115

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X AC00393 OR
NaturopathGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 175F00000X 0972 OR Primary

Addresses

Primary practice location

3007 SE Belmont St
Portland, OR 97214-4026

Mailing address

3007 SE Belmont St
Portland, OR 97214-4026
Phone (503) 445-7115

Other names 1

  • Natural Choices Health Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1366586703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144026",
            "telephone_number": "503-445-7115",
            "fax_number": "503-445-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144026",
            "telephone_number": "503-445-7115",
            "fax_number": "503-445-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEIVAN JINNAH, ND, LAC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "JINNAH",
        "authorized_official_first_name": "KEIVAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-445-7115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND, LAC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00393",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "OR",
            "license": "0972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Natural Choices Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 2, 2018; 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.