Emily Costello, DACM, MACOM, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Practice address

11775 SW Greenburg Rd
Tigard, OR 97223-6445

Phone

(503) 381-2600

NPI assigned

May 16, 2023

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

Practice roles

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.

• The Mend PDX LLC

  • Acupuncturist
  • Portland, OR
  • NPI 1467161455
  NPD (past)

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1811688492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11495 SW GREENBURG RD APT B",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235319",
            "telephone_number": "315-209-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11775 SW GREENBURG RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236445",
            "telephone_number": "503-381-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "EMILY",
        "credential": "DACM, MACOM, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Cosgrove, APRN, NP-C
• Adam J Costa
• Costco Wholesale Corporation (Costco Optical #111)
• Costco Wholesale Corporation (Costco Hearing Aid #111)
• Costco Wholesale Corporation
• Alexandra Ainge Cottle, MA
• Kari Marie Coughlin
• Tykeria Lorelle Cowart
• Taylor Matthew Cowman
• Naqueita Anita Cox

• Acupuncturist in Tigard, OR
• Providers in Tigard, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.