Individual provider Active NPI

Lori Michele Petras, L.AC; MAOM

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1649424326
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Practice address
3922 NE Sumner St
Portland, OR 97211-8071
Phone
(503) 753-4402
NPI assigned
Nov 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X Primary

Addresses

Primary practice location

3922 NE Sumner St
Portland, OR 97211-8071

Mailing address

3922 NE Sumner St
Portland, OR 97211-8071
Phone (503) 753-4402

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

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1649424326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3922 NE SUMNER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972118071",
            "telephone_number": "503-753-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3922 NE SUMNER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972118071",
            "telephone_number": "503-753-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAS",
        "first_name": "LORI",
        "middle_name": "MICHELE",
        "credential": "L.AC; MAOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "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 Nov 7, 2008; 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.