NPIMap

Organization Active NPI

Clackamas Center for Traditional Medicine, Inc

Doing business as Lake Road Acupuncture & Massage

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1679754709
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00831 Issued in OR
Legal business name
CLACKAMAS CENTER FOR TRADITIONAL MEDICINE, INC
Doing business as
Lake Road Acupuncture & Massage
Practice address
7831 SE Lake Rd
Suite 101
Portland, OR 97267-2193
Phone
(503) 653-1468
Fax
(503) 496-0727
NPI assigned
Nov 16, 2007
Last updated
Jun 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Authorized official

Name
Ms. Carol Kim Griesmeyer, LAC, RNNPI 1952445439
Title
President
Phone
(503) 653-1468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00831 OR Primary

Addresses

Primary practice location

7831 SE Lake Rd
Suite 101
Portland, OR 97267-2193

Mailing address

7831 SE Lake Rd
Suite 101
Portland, OR 97267-2193
Phone (503) 653-1468

Other names 1

  • Lake Road Acupuncture & Massage Doing business as

National Provider Directory

National Provider Directory

Locations

7831 SE Lake Rd
Ste 101
Portland, OR 97267
Phone (503) 653-1468

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1679754709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7831 SE LAKE RD",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972672193",
            "telephone_number": "503-653-1468",
            "fax_number": "503-496-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7831 SE LAKE RD",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972672193",
            "telephone_number": "503-653-1468",
            "fax_number": "503-496-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLACKAMAS CENTER FOR TRADITIONAL MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "GRIESMEYER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-653-1468",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LAC, RN"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Road Acupuncture & Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 21, 2010; 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.