Active NPI
Eduardo Fernandez, L.AC.
- Acupuncturist
- The Dalles, OR
National Provider Identifier
1639107568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC00255
- Practice address
- 1800 E 19TH St
The Dalles, OR 97058-3389 - Phone
- (541) 296-7585
- Fax
- (541) 296-7610
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC00255 | OR | Primary |
Addresses
Primary practice location
1800 E 19TH St
The Dalles, OR 97058-3389
Mailing address
4715 NE 14TH Ave.
Portland, OR 97211
Phone (971) 998-3155
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 |
|---|---|---|---|
| AC00255 | OR | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639107568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4715 NE 14TH AVE.",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97211",
"telephone_number": "971-998-3155",
"fax_number": "503-282-1697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 E 19TH ST",
"city": "THE DALLES",
"state": "OR",
"postal_code": "970583389",
"telephone_number": "541-296-7585",
"fax_number": "541-296-7610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "EDUARDO",
"credential": "L.AC.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC00255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Dalles, OR
Sources for this page
- 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.