Kseniya A Stevens, L.AC., DIPL. O.M.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC60066963 Issued in WA

Practice address

124 NW 2ND St
Prineville, OR 97754-1808

Phone

(541) 480-4970

Fax

(425) 876-2274

NPI assigned

Jan 4, 2007

Last updated

Jan 2, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1427105345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NW 2ND ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541808",
            "telephone_number": "541-480-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NW 2ND ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541808",
            "telephone_number": "541-480-4970",
            "fax_number": "425-876-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KSENIYA",
        "middle_name": "A",
        "credential": "L.AC., DIPL. O.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01017",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60066963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Charles Health System, Inc. (St. Charles Prineville)
• Micalene Stafford, LMT
• Justyn Reid Staten, CADC-I, PSS, CRM
• Johannah Elizabeth Stephens
• Matthew V Stern, RPH
• Altara Sue Stever, CADC I
• Lindsey Stewart, QMHA
• Cynthia Stidd, LCSW
• Still Waters Counseling Group
• Crystal Ann Strader, PSS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.