Tracy Andersen, DAOM, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC00816 Issued in OR

Practice address

2301 NW Thurman St
Suite O
Portland, OR 97210-2581

Phone

(503) 250-3012

Fax

(503) 208-8028

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tracy Andersen, Daom, Lac

  • Acupuncturist
  • Portland, OR
  • NPI 1346065075
  NPD Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1720138795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 NW THURMAN ST",
            "address_2": "SUITE O",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102581",
            "telephone_number": "503-250-3012",
            "fax_number": "503-208-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 NW THURMAN ST",
            "address_2": "SUITE O",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102581",
            "telephone_number": "503-250-3012",
            "fax_number": "503-208-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "TRACY",
        "credential": "DAOM, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen C Andersen, CNM
• Megan Ann Andersen
• Peggy Sunae Andersen, ED.S.
• Peter Edward Andersen, MD
• Steven S Andersen, MD
• Margaret Elaine Anderson Brunner, DDS
• Laurel Rene Anderson Cowell, MD
• Telia Nicole Anderson-Grant, NON CREDENTIAL
• Carmaleta Margurita Anderson-Hunter, QMHA, AAS, CADC I
• Kerri Elizabeth Anderson-Linde, LPC

• All providers in Portland, OR
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.