Brian Tetz, LMT

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC191454 Issued in OR

Practice address

23751 SW Elderberry LN
West Linn, OR 97068-9111

Phone

(719) 393-3574

NPI assigned

Nov 13, 2018

Last updated

Dec 30, 2018By the provider in NPPES

Sex

Male

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": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546128000000",
    "number": "1508334194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23751 SW ELDERBERRY LN",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970689111",
            "telephone_number": "719-393-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23751 SW ELDERBERRY LN",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970689111",
            "telephone_number": "719-393-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETZ",
        "first_name": "BRIAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24319",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC191454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in West Linn, OR
• Providers in West Linn, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2018; 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.