NPIMap

Organization Active NPI

Dr. Lu's Acupunture & Massage Clinic, LLC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1790097772
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00498 Issued in OR
Legal business name
DR. LU'S ACUPUNTURE & MASSAGE CLINIC, LLC
Practice address
12778 SE Stark St.
Blaza 125, BLDG B
Portland, OR 97233
Phone
(503) 317-3113
Fax
(503) 459-4709
NPI assigned
Jul 8, 2010
Last updated
Oct 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Authorized official

Name
Dr. Yan Lu, LAC DAOMNPI 1629197934
Title
Lac
Phone
(503) 317-3113

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00002588 WA
Acupuncturist 171100000X AC00498 OR Primary

Addresses

Primary practice location

12778 SE Stark St.
Blaza 125, BLDG B
Portland, OR 97233

Mailing address

12778 SE Stark St.
Blaza 125, BLDG B
Portland, OR 97233
Phone (503) 317-3113

National Provider Directory

National Provider Directory

Locations

12778 SE Stark St
Bldg B
Portland, OR 97233
Phone (503) 317-3113

Practitioners & affiliated clinicians

Practitioners 4

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": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1790097772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12778 SE STARK ST.",
            "address_2": "BLAZA 125, BLDG B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97233",
            "telephone_number": "503-317-3113",
            "fax_number": "503-459-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12778 SE STARK ST.",
            "address_2": "BLAZA 125, BLDG B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97233",
            "telephone_number": "503-317-3113",
            "fax_number": "503-459-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LU'S ACUPUNTURE & MASSAGE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "LAC",
        "authorized_official_telephone_number": "503-317-3113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LAC DAOM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00002588",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 8, 2014; 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.