NPIMap

Organization Active NPI

Elements Holistic Wellness

  • Acupuncturist
  • Clackamas, OR
National Provider Identifier
1376822692
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC150496 Issued in OR
Legal business name
ELEMENTS HOLISTIC WELLNESS
Practice address
15240 SE 82ND Dr
Clackamas, OR 97015-9606
Phone
(503) 656-5510
NPI assigned
Aug 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Mychell Vincent, LAC
Title
Acupuncturist
Phone
(503) 656-5510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC150496 OR Primary

Addresses

Primary practice location

15240 SE 82ND Dr
Clackamas, OR 97015-9606

Mailing address

15240 SE 82ND Dr
Clackamas, OR 97015
Phone (503) 656-5510

National Provider Directory

National Provider Directory
Tax ID family
Elements Holistic Wellness3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15240 SE 82nd Dr
Clackamas, OR 97015
Phone (503) 481-9563

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1376822692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15240 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-656-5510",
            "fax_number": "503-656-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15240 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159606",
            "telephone_number": "503-656-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTS HOLISTIC WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "MYCHELL",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "503-656-5510",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC150496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.