Jonathan Irvin, LAC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC184368 Issued in OR

Practice address

2121 W Burnside St
Portland, OR 97210-3519

Phone

(503) 432-8348

NPI assigned

Oct 23, 2017

Last updated

Jul 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• GFM LLC

  dba Great Forest Medicine Acupuncture and Herbs

  • Clinic/Center
  • Portland, OR
  • NPI 1801413240
  NPD Authorized official
• Great Forest Medicine

  • Clinic/Center
  • Seattle, WA
  • NPI 1497295521
  Authorized official Same address or phone

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1427569052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 SE 41ST AVE APT 16",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143259",
            "telephone_number": "206-305-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103519",
            "telephone_number": "503-432-8348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 SE Division St Ste 114",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972021042",
            "country_code": "US",
            "telephone_number": "206-305-8709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "JONATHAN",
        "credential": "LAC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-23",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC184368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Ironbar
• Robert Bruce Ironside, M.D.
• Makenzie Ann Irrgang
• Candace Nichole Irvin
• Gary Irvin
• Michael Irvin
• Michal Irvin, MA
• Brenda Davis Irvine, RN, IBCLC
• Christina Irvine, PH.D.
• Christina Hamme Irvine, PSY.D.

• 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 Jul 1, 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.