Organization Active NPI

Stumptown Acupuncture LLC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1407641574
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
STUMPTOWN ACUPUNCTURE LLC
Practice address
1110 SE Alder St Ste 110
Portland, OR 97214-2400
Phone
(971) 417-6205
NPI assigned
Apr 10, 2025
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Bradley Sasao-Ruef, LACNPI 1528643657
Title
Owner/Provider
Phone
(971) 417-6205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1110 SE Alder St Ste 110
Portland, OR 97214-2400

Mailing address

1110 SE Alder St Ste 110
Portland, OR 97214-2400
Phone (971) 417-6205

National Provider Directory

National Provider Directory

Locations

1110 SE Alder St
Ste 110
Portland, OR 97214
Phone (971) 417-6205

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": "1744243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1407641574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "971-417-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "971-417-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUMPTOWN ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "SASAO-RUEF",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "971-417-6205",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 21, 2025; 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.