Individual provider Active NPI

Mary J Grabowska, ND, LM, LAC

  • Naturopath
  • Portland, OR
National Provider Identifier
1578597829
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
794 Issued in OR
Practice address
2207 NE Broadway St
Suite 200
Portland, OR 97232-1791
Phone
(503) 236-6006
Fax
(503) 232-3436
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00272 OR
Naturopath 175F00000X 794 OR Primary
Midwife 176B00000X MW00000176 WA

Addresses

Primary practice location

2207 NE Broadway St
Suite 200
Portland, OR 97232-1791

Mailing address

2207 NE Broadway St
Suite 200
Portland, OR 97232-1791
Phone (503) 236-6006

Other identifiers 2

IdentifierTypeStateIssuer
7102759MedicaidWA
119870MedicaidOR

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

LicenseStateTypeSpecialty
AC00272ORMDAcupuncturist
794ORMDNaturopath
MW00000176WAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Family Clinic Acupuncturist CurrentSince Jan 3, 2021 Accepting new patients
Earth Source Medicine Past Accepting new patients

Locations

2207 NE Broadway St
Ste 200
Portland, OR 97232
Phone (503) 236-6006

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1578597829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 NE BROADWAY ST",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321791",
            "telephone_number": "503-236-6006",
            "fax_number": "503-232-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 NE BROADWAY ST",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321791",
            "telephone_number": "503-236-6006",
            "fax_number": "503-232-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABOWSKA",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "ND, LM, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00272",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "794",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "WA",
            "license": "MW00000176",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102759",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119870",
            "state": "OR"
        }
    ],
    "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 May 31, 2016; 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.