Active NPI
Autumn Lyn Waters, LMT
- Homeopath
- Salem, OR
National Provider Identifier
1407138746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homeopath
- License
- LMT 17282
- Practice address
- 417 Lancaster Dr NE
Salem, OR 97301-4729 - Phone
- (503) 371-4968
- NPI assigned
- Sep 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Homeopath | 175L00000X | LMT 17282 | OR | Primary |
Addresses
Primary practice location
417 Lancaster Dr NE
Salem, OR 97301-4729
Mailing address
417 Lancaster Dr NE
Salem, OR 97301-4729
Phone (503) 371-4968
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 |
|---|---|---|---|
| LMT 17282 | OR | MD | Homeopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1407138746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 LANCASTER DR NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973014729",
"telephone_number": "503-371-4968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 LANCASTER DR NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973014729",
"telephone_number": "503-371-4968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "AUTUMN",
"middle_name": "LYN",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "175L00000X",
"taxonomy_group": "",
"desc": "Homeopath",
"state": "OR",
"license": "LMT 17282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.