NPIMap

Organization Active NPI

Vibrant Life Acupuncture

  • Acupuncturist
  • Lake Oswego, OR
National Provider Identifier
1386009348
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC159474 Issued in OR
Legal business name
VIBRANT LIFE ACUPUNCTURE
Practice address
15962 Boones Ferry Rd
Suite 202
Lake Oswego, OR 97035-4351
Phone
(503) 515-7702
NPI assigned
Dec 17, 2015
Last updated
Apr 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
Stacy SpenceNPI 1366795361
Title
Acupuncturist
Phone
(503) 515-7702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X AC159474 OR Primary

Addresses

Primary practice location

15962 Boones Ferry Rd
Suite 202
Lake Oswego, OR 97035-4351

Mailing address

15962 Boones Ferry Rd
Suite 202
Lake Oswego, OR 97035-4351
Phone (503) 515-7702

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1386009348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15962 BOONES FERRY RD",
            "address_2": "SUITE 202",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354351",
            "telephone_number": "503-515-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15962 BOONES FERRY RD",
            "address_2": "SUITE 202",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354351",
            "telephone_number": "503-515-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT LIFE ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "503-515-7702"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC159474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.