NPIMap

Organization Active NPI

Woodstock Wellness Center LLC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1578730982
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00513 Issued in OR
Legal business name
WOODSTOCK WELLNESS CENTER LLC
Practice address
4512 SE Woodstock Blvd
Portland, OR 97206-6274
Phone
(503) 777-2776
NPI assigned
May 14, 2008
Last updated
May 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Miss Angela Tisci, LACNPI 1508942889
Title
Acupuncturist
Phone
(503) 777-2776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X AC00513 OR Primary

Addresses

Primary practice location

4512 SE Woodstock Blvd
Portland, OR 97206-6274

Mailing address

4512 SE Woodstock Blvd
Portland, OR 97206-6274

National Provider Directory

National Provider Directory
Tax ID family
Woodstock Wellness Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4512 SE Woodstock Blvd
Portland, OR 97206
Phone (503) 777-2776

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1578730982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 SE WOODSTOCK BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972066274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 SE WOODSTOCK BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972066274",
            "telephone_number": "503-777-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "TISCI",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "503-777-2776",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00513",
            "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 May 14, 2008; 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.