Kaecee Creveling, L.AC., MACOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC160521 Issued in OR

Practice address

1615 NW 23Rd Ave
Suite 1
Portland, OR 97210-2557

Phone

(206) 910-8765

NPI assigned

Jan 9, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1700123809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 NE 79TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136618",
            "telephone_number": "206-910-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 NW 23RD AVE",
            "address_2": "SUITE 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102557",
            "telephone_number": "206-910-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREVELING",
        "first_name": "KAECEE",
        "name_prefix": "Ms.",
        "credential": "L.AC., MACOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC160521",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60322012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creston SNF Healthcare LLC
• Crestview Operations, LLC
• Crestview Recovery Services, LLC
• Emily Creswick, LPN
• Joachim Creten, MASSAGE THERAPIST
• Jacob E. Creviston, DNP, RN, PMHNP-BC
• Criag W. Calhoun MD PC
• Michaela Leanne Cribb, NP
• Lindsey Crider, RN, BSN
• Carrie Eileen Crimin, BSN, L.AC.

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.