Active NPI
Marc Gadoua, L AC
- Acupuncturist
- Portland, OR
National Provider Identifier
1487682837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- LAC00208
- Practice address
- 407 NE 12TH
#205
Portland, OR 97232 - Phone
- (503) 872-9861
- Fax
- (503) 232-7440
- NPI assigned
- Jun 28, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | LAC00208 | OR | Primary |
Addresses
Primary practice location
407 NE 12TH
#205
Portland, OR 97232
Mailing address
407 NE 12TH
#205
Portland, OR 97232
Phone (503) 872-9861
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAC00208 | OR | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heaven-Earth Acupuncture | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Acupuncturist
- Portland, OR
- NPI 1457624991
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487682837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 NE 12TH",
"address_2": "#205",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97232",
"telephone_number": "503-872-9861",
"fax_number": "503-232-7440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 NE 12TH",
"address_2": "#205",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97232",
"telephone_number": "503-872-9861",
"fax_number": "503-232-7440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GADOUA",
"first_name": "MARC",
"credential": "L AC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "LAC00208",
"primary": true
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.