Organization Active NPI

Brooklyn Community Acupuncture and Wellness, LLC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1669873154
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC156229 Issued in OR
Legal business name
BROOKLYN COMMUNITY ACUPUNCTURE AND WELLNESS, LLC
Practice address
3205 SE 13TH Ave
Suite 200
Portland, OR 97202-2461
Phone
(503) 233-4341
NPI assigned
Sep 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Authorized official

Name
Ms. Kristin Vera Brink, LAC
Title
Manager/Owner
Phone
(310) 773-6649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X AC156229 OR Primary

Addresses

Primary practice location

3205 SE 13TH Ave
Suite 200
Portland, OR 97202-2461

Mailing address

3205 SE 13TH Ave
Suite 200
Portland, OR 97202-2461
Phone (503) 233-4341

Other names 1

  • BCAW Other name

National Provider Directory

National Provider Directory

Locations

3205 SE 13th Ave
Ste 200
Portland, OR 97202
Phone (503) 233-4341

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1669873154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 SE 13TH AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022461",
            "telephone_number": "503-233-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 SE 13TH AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022461",
            "telephone_number": "503-233-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN COMMUNITY ACUPUNCTURE AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "VERA",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "310-773-6649",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC156229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BCAW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 16, 2014; 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.