NPIMap

Organization Active NPI

Vitalize Acupuncture and Herbal Medicine, LLC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1659630762
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC156204 Issued in OR
Legal business name
VITALIZE ACUPUNCTURE AND HERBAL MEDICINE, LLC
Practice address
511 SW 10TH Ave Ste 610
Portland, OR 97205-2707
Phone
(503) 756-2743
NPI assigned
May 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Authorized official

Name
Jessica Gilchrist
Title
Owner
Phone
(503) 756-2743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X AC156204 OR Primary

Addresses

Primary practice location

511 SW 10TH Ave Ste 610
Portland, OR 97205-2707

Mailing address

511 SW 10TH Ave Ste 610
Portland, OR 97205-2707
Phone (503) 756-2743

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1659630762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 610",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052707",
            "telephone_number": "503-756-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 610",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052707",
            "telephone_number": "503-756-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALIZE ACUPUNCTURE AND HERBAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "GILCHRIST",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-756-2743"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC156204",
            "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 May 9, 2012; 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.