Chase Garrett Waters, DAOM, MTCM, LAC,

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC186066 Issued in OR

Practice address

4160 NE Sandy Blvd
Portland, OR 97212-5336

Phone

(503) 249-9000

NPI assigned

Dec 11, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Chase Garrett Waters Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Urgent Care Express PC

  • Urgent Care Clinic/Center
  • Portland, OR
  • NPI 1639428436
  NPD
• Portland Wellness Care

  • Rehabilitation Clinic/Center
  • Portland, OR
  • NPI 1801286117
  NPD (past)

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

{
    "created_epoch": "1481414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1609310671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "879 41ST AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950624420",
            "telephone_number": "831-428-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125336",
            "telephone_number": "503-249-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "CHASE",
        "middle_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "DAOM, MTCM, LAC,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-11",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17367",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC186066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHASE",
            "last_name": "WATERS",
            "middle_name": "GARRETT",
            "credential": "LAC, MTCM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jean Louise Waterman, LCSW
• Allison Waters, MSW, MDIV, QMHP
• Amy B Waters, MD
• Anna Waters, ED.D.
• Carlesha Waters
• Daniel Waters
• Elisha M Waters, BA, CADCI
• Elizabeth Ellen Waters, IBCLC, RLC, CPPD
• Georgina Claire Waters, MBBS
• Igwe Waters

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.