Active NPI
Melanie Misenheimer, LAC
- Acupuncturist
- Portland, OR
National Provider Identifier
1558790345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC164953
- Practice address
- 1804 NE MLK Jr Blvd Ste a-B
Portland, OR 97212-3980 - Phone
- (971) 302-6614
- NPI assigned
- Nov 2, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | AC164953 | OR | Primary |
Addresses
Primary practice location
1804 NE MLK Jr Blvd Ste a-B
Portland, OR 97212-3980
Mailing address
10909 SW Boones Ferry Rd Unit B
Portland, OR 97219-7725
Phone (704) 995-9926
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 |
|---|---|---|---|
| AC164953 | OR | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383350400000",
"number": "1558790345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10909 SW BOONES FERRY RD UNIT B",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972197725",
"telephone_number": "704-995-9926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1804 NE MLK JR BLVD STE A-B",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972123980",
"telephone_number": "971-302-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISENHEIMER",
"first_name": "MELANIE",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-02",
"last_updated": "2013-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC164953",
"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 Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.