Michelle Dianne Young, ND, LAC

Primary specialty

NaturopathTaxonomy code 175F00000X

License

2000 Issued in OR

Practice address

4670 SW Washington Ave
Beaverton, OR 97005-0530

Phone

(503) 646-8575

Fax

(503) 526-0783

NPI assigned

Oct 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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 and National Provider Directory roles.

• Mijo

  • Naturopath
  • Beaverton, OR
  • NPI 1598591331

  Acupuncturist

  NPD Authorized official

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

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1457789661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5806 DUNIWAY AVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271939",
            "telephone_number": "972-571-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 SW WASHINGTON AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050530",
            "telephone_number": "503-646-8575",
            "fax_number": "503-526-0783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18840 SW Boones Ferry Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970629688",
            "country_code": "US",
            "telephone_number": "503-772-3297",
            "fax_number": "971-246-5458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MICHELLE",
        "middle_name": "DIANNE",
        "credential": "ND, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-25",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC168160",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "2000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500667513",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500681144",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Young, LMT
• Benjamin Wun Sing Young, PA-C
• Camry Young, LPC
• Charles Brenton Young, QMHP
• David S. Young, D.C.
• Masa Safic Youngblood, RDH
• Diana Youssef, PHARMD
• Alexander Chan Yu, MD, PHD
• Chien-Ching Yu
• Luna Yu

• All providers in Beaverton, OR
• Naturopath in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.