Olga Smith Dongvillo, LICENSED ACUPUNCTURI

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

00204 Issued in OR

Practice address

165 E. 1St Ave.
Estacada, OR 97023-9435

Phone

(503) 630-6555

Fax

(503) 630-2838

NPI assigned

Feb 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• GHC Inc

  • Acupuncturist
  • Estacada, OR
  • NPI 1083970768
  NPD (past) Authorized official

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629110499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 E. 1ST AVE.",
            "city": "ESTACADA",
            "state": "OR",
            "postal_code": "970239435",
            "telephone_number": "503-630-6555",
            "fax_number": "503-630-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E. 1ST AVE.",
            "city": "ESTACADA",
            "state": "OR",
            "postal_code": "970239435",
            "telephone_number": "503-630-6555",
            "fax_number": "503-630-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONGVILLO",
        "first_name": "OLGA",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "LICENSED ACUPUNCTURI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "00204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richina M.K. Davis, LPN
• Dedicated Sleep LLC (Sleep Health & Wellness NW)
• Dedicated Sleep, LLC (Sleep Health & Wellness NW)
• Rudena Marie Delazerda
• Megan Michelle Diebel, CHW
• Konnie Joanne Ebert, BSN
• Laura Evelyn Edwards, MS, LPC
• Bonnie Sue Erickson, ATC, CSCS
• Maria J Escobar, MSW, LCSW
• Estacada Chiropractic Clinic Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.