Kjell Moline, L.Ac.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC01254 Issued in OR

Legal business name

KJELL MOLINE, L.AC.

Practice address

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

Phone

(503) 241-6505

Fax

(503) 296-2205

NPI assigned

Dec 30, 2011

Organization subpart

No

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 1

Addresses

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325203200000",
    "number": "1801166384",
    "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": "KJELL MOLINE, L.AC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-30",
        "last_updated": "2011-12-30",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Portland, OR
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• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.