Organization Active NPI

Confluence Clinic, LLC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1801165048
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01254 Issued in OR
Legal business name
CONFLUENCE CLINIC, LLC
Practice address
506 SW 6TH Ave
Suite 801
Portland, OR 97204-1533
Phone
(503) 241-6505
Fax
(503) 296-2205
NPI assigned
Dec 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Authorized official

Name
Mr. Kjell Cameron Moline, L.AC.
Title
Owner
Phone
(503) 241-6505

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC01254 OR Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X 18104 OR

Addresses

Primary practice location

506 SW 6TH Ave
Suite 801
Portland, OR 97204-1533

Mailing address

506 SW 6TH Ave
Suite 801
Portland, OR 97204-1533
Phone (503) 241-6505

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1801165048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 SW 6TH AVE",
            "address_2": "SUITE 801",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041533",
            "telephone_number": "503-241-6505",
            "fax_number": "503-296-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 SW 6TH AVE",
            "address_2": "SUITE 801",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041533",
            "telephone_number": "503-241-6505",
            "fax_number": "503-296-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFLUENCE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "MOLINE",
        "authorized_official_first_name": "KJELL",
        "authorized_official_middle_name": "CAMERON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-241-6505",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01254",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "18104",
            "primary": false
        }
    ],
    "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 Dec 16, 2011; 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.