Active NPI
Brooklyn Community Acupuncture and Wellness, LLC
- Acupuncturist
- Portland, OR
National Provider Identifier
1669873154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC156229
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 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
National Provider Directory
National Provider DirectoryLocations
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.