Vital Life Acupuncture Clinic, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VITAL LIFE ACUPUNCTURE CLINIC, LLC

Practice address

3007 SE Belmont St
Portland, OR 97214-4026

Phone

(503) 445-7115

Fax

(503) 445-7116

NPI assigned

Nov 7, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Lita Buttolph, DSOMNPI 1679054472

Title

Acupuncturist

Phone

(503) 358-0739

Specialties & licenses 1

Addresses

Other names 1

• Lita Buttolph Doing business as

Practitioners 1

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

• Lita Buttolph, LAC

  • Acupuncturist
  • Portland, OR
  • NPI 1679054472
  NPD Authorized official

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647043200000",
    "number": "1679041602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 SE 46TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972067039",
            "telephone_number": "503-358-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144026",
            "telephone_number": "503-445-7115",
            "fax_number": "503-445-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL LIFE ACUPUNCTURE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A",
        "authorized_official_last_name": "BUTTOLPH",
        "authorized_official_first_name": "LITA",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "503-358-0739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSOM"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lita Buttolph",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lita Buttolph",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Visualeyes Optometric, Inc
• Sheila Visvanathan, RD
• Vital Bodyworks
• Vital Health Center, Inc.
• Vital Health Clinic LLC
• Alexandra Vitale
• Vitality Physical Therapy Northwest LLC
• Vitalize Acupuncture and Herbal Medicine, LLC
• Vitalize Acupuncture Inc.
• David Mark Vitello, AGPCNP

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; 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.