Individual provider Active NPI

Bradley James Sasao-Ruef, LAC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1528643657
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC203559 Issued in OR
Practice address
1110 SE Alder St Ste 110
Portland, OR 97214-2400
Phone
(971) 417-6205
NPI assigned
Mar 10, 2021
Last updated
Sep 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC203559 OR Primary

Addresses

Primary practice location

1110 SE Alder St Ste 110
Portland, OR 97214-2400

Mailing address

1110 SE Alder St Ste 110
Portland, OR 97214-2400
Phone (971) 417-6205

Other identifiers 1

IdentifierTypeStateIssuer
500840197MedicaidOR

Other names 1

  • Bradley James Sasao-Ruef Professional name

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stumptown Acupuncture LLC Acupuncturist CurrentSince Apr 13, 2025 Accepting new patients

Locations

1110 SE Alder St
Ste 110
Portland, OR 97214
Phone (971) 417-6205

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.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1528643657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "971-417-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "971-417-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASAO-RUEF",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC203559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500840197",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRADLEY",
            "last_name": "SASAO-RUEF",
            "middle_name": "JAMES",
            "credential": "LAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Sep 15, 2025; 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.