NPIMap

Organization Active NPI

Metta River LLC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1740997485
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
METTA RIVER LLC
Practice address
3605 SE 26TH Ave
Portland, OR 97202-2953
Phone
(503) 234-0325
NPI assigned
Nov 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Shawn P Kinsella, LACNPI 1265738272
Title
Owner
Phone
(503) 234-0325

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
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X Primary

Addresses

Primary practice location

3605 SE 26TH Ave
Portland, OR 97202-2953

Mailing address

3605 SE 26TH Ave
Portland, OR 97202-2953
Phone (503) 234-0325

Other names 1

  • Metta River LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://acusimple.com/portal/6947

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1740997485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 SE 26TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022953",
            "telephone_number": "503-234-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 SE 26TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022953",
            "telephone_number": "503-234-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METTA RIVER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "KINSELLA",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-234-0325",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://acusimple.com/portal/6947",
            "affiliation": "N",
            "endpointDescription": "patient portal",
            "address_1": "3605 SE 26th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972022953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Metta River LLC",
            "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 Nov 2, 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.