Alexis Miranda Barker, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC202639 Issued in OR

Practice address

4929 NE 30TH Ave
Zen Space Healing
Portland, OR 97211

Phone

(503) 281-0681

NPI assigned

Apr 18, 2011

Reactivated

Feb 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mandala Medicine Acupuncture LLC

  • Acupuncturist
  • Portland, OR
  • NPI 1952600124
  NPD
• Evolve Wellness

  • Chiropractor
  • Portland, OR
  • NPI 1033518709
  NPD (past)

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1629368196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142073",
            "telephone_number": "503-758-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 NE 30TH AVE",
            "address_2": "ZEN SPACE HEALING",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97211",
            "telephone_number": "503-281-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "ALEXIS",
        "middle_name": "MIRANDA",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "deactivation_date": "2020-12-08",
        "reactivation_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17304",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC202639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Sue Barile, BA CADC I
• Tara Anne Barkell
• Ellen Carla Barker-Anderson, APNP
• Alan Freund Barker, MD
• Alexandria Barker, CCC-SLP
• Christopher S Barker, LCSW
• Joshua Barker
• Merrick Dylan Barker
• Michelle Lee Barker, LMT
• Teresa Barker, MT

• 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 Feb 8, 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.