Sportland Acupuncture LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC156421 Issued in OR

Legal business name

SPORTLAND ACUPUNCTURE LLC

Doing business as

Sportland Acupuncture

Practice address

1025 N Humboldt
Portland, OR 97217

Phone

(503) 679-3872

NPI assigned

Sep 12, 2012

Organization subpart

No

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

Authorized official

Name

Genevieve Moore Renae Moore, LAC

Title

Acupuncturist

Phone

(503) 679-3872

Specialties & licenses 1

Addresses

Other names 1

• Sportland Acupuncture Doing business as

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1417207994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N HUMBOLDT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97217",
            "telephone_number": "503-679-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N HUMBOLDT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97217",
            "telephone_number": "503-679-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTLAND ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "GENEVIEVE MOORE",
        "authorized_official_middle_name": "RENAE",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "503-679-3872",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC156421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sportland Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mason D Spong, PA-C
• Patricia M Spooner, CNM
• Rachel Spooner
• Erika Nguyen Sporleder, CRNA
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• Samantha Joelle Sposito
• Daniel James Spotanski, CRM

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.