Active NPI
Carol Patricia Congdon, LAC
- Acupuncturist
- Portland, OR
National Provider Identifier
1598948978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 154157
- Practice address
- 4425 SW Corbett Ave
Portland, OR 97239-4260 - Phone
- (503) 317-6347
- NPI assigned
- Dec 9, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7381 | OR | |
| Acupuncturist | 171100000X | 154157 | OR | Primary |
Addresses
Primary practice location
4425 SW Corbett Ave
Portland, OR 97239-4260
Mailing address
4425 SW Corbett Ave
Portland, OR 97239-4260
Phone (503) 317-6347
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 |
|---|---|---|---|
| 154157 | OR | MD | Acupuncturist |
| 7381 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525046400000",
"number": "1598948978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 SW CORBETT AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394260",
"telephone_number": "503-317-6347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4425 SW CORBETT AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394260",
"telephone_number": "503-317-6347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONGDON",
"first_name": "CAROL",
"middle_name": "PATRICIA",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-09",
"last_updated": "2018-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "7381",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "154157",
"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 Apr 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.