NPIMap

Organization Active NPI

White Phoenix Acupuncture

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1417207184
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1510566-3 Issued in OR
Legal business name
WHITE PHOENIX ACUPUNCTURE
Practice address
6913 SE Foster Rd
Portland, OR 97206-4547
Phone
(503) 235-7653
Fax
(866) 398-6092
NPI assigned
Sep 10, 2012
Last updated
Dec 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Allyndreth Stead, L.AC.NPI 1548571847
Title
President & Ceo
Phone
(503) 235-7653

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 1510566-3 OR Primary
Acupuncturist 171100000X

Addresses

Primary practice location

6913 SE Foster Rd
Portland, OR 97206-4547

Mailing address

6913 SE Foster Rd
Portland, OR 97206-4547
Phone (503) 235-7653

National Provider Directory

National Provider Directory

Locations

6913 SE Foster Rd
Portland, OR 97206
Phone (503) 235-7653

8235 SE 13th Ave
Ste 11
Portland, OR 97202
Phone (503) 746-9403

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1417207184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6913 SE FOSTER RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064547",
            "telephone_number": "503-235-7653",
            "fax_number": "503-398-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6913 SE FOSTER RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064547",
            "telephone_number": "503-235-7653",
            "fax_number": "866-398-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE PHOENIX ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "STEAD",
        "authorized_official_first_name": "ALLYNDRETH",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "503-235-7653",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "1510566-3",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Dec 3, 2020; 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.