Active NPI
Jacqueline R Buckner, LMT
- Specialist
- North Plains, OR
National Provider Identifier
1689804577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 10754
- Practice address
- 17733 NW Pumpkin Ridge Rd
North Plains, OR 97133-6155 - Phone
- (503) 804-8048
- NPI assigned
- Jul 25, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 10754 | OR | Primary |
Addresses
Primary practice location
17733 NW Pumpkin Ridge Rd
North Plains, OR 97133-6155
Mailing address
17733 NW Pumpkin Ridge Rd
North Plains, OR 97133-6155
Phone (503) 804-8048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10754 | OR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248480000000",
"number": "1689804577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17733 NW PUMPKIN RIDGE RD",
"city": "NORTH PLAINS",
"state": "OR",
"postal_code": "971336155",
"telephone_number": "503-804-8048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17733 NW PUMPKIN RIDGE RD",
"city": "NORTH PLAINS",
"state": "OR",
"postal_code": "971336155",
"telephone_number": "503-804-8048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKNER",
"first_name": "JACQUELINE",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-25",
"last_updated": "2009-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "10754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Plains, OR
- Lauren Elise Adamski
- Andrew Lee Thompson DMD PC & Assoc.
- Andrew Lee Thompson DMD PC & Assoc.
- Associated Physicians of North Plains
- Carrie Marie Brisbine
- Claro Speech Therapy LLC
- Robert Lester Colpean III, LCSW
- Contour Chiropractic Clinic PC
- Jean Habecker Cuyler, RADIOLOGIC TECH
- Candace Louise Enslow, RDH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.