Active NPI
Jenifer Lyn Gullotto, ND
- Naturopath
- Lake Oswego, OR
National Provider Identifier
1386283224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 4294
- Practice address
- 17084 Pilkington Rd
Lake Oswego, OR 97035-5352 - Phone
- (503) 303-5472
- NPI assigned
- Dec 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 4294 | OR | Primary |
Addresses
Primary practice location
17084 Pilkington Rd
Lake Oswego, OR 97035-5352
Mailing address
1000 SW Vista Ave Apt 707
Portland, OR 97205-1137
Phone (559) 827-3003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4294 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1386283224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 SW VISTA AVE APT 707",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051137",
"telephone_number": "559-827-3003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17084 PILKINGTON RD",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970355352",
"telephone_number": "503-303-5472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLOTTO",
"first_name": "JENIFER",
"middle_name": "LYN",
"name_prefix": "Dr.",
"credential": "ND",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-23",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "OR",
"license": "4294",
"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 Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.