Tiffany Rose Petry, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC212915 Issued in OR

Practice address

315 W Broadway Ste 100
Eugene, OR 97401-3081

Phone

(541) 968-3395

Fax

(541) 470-8729

NPI assigned

Jan 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Compass Proactive Health Care LLC

  • Acupuncturist
  • Eugene, OR
  • NPI 1790490035
  NPD

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1821702200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 PORTLAND ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974055140",
            "telephone_number": "541-968-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W BROADWAY STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013081",
            "telephone_number": "541-968-3395",
            "fax_number": "541-470-8729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3155 Portland St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974055140",
            "country_code": "US",
            "telephone_number": "541-968-3395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRY",
        "first_name": "TIFFANY",
        "middle_name": "ROSE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "PTA9230",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": "LMT-12041",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC212915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Petet
• Stephen Pethick, PHD
• Natasa Petrac, M.D.
• Kara Lynn Petredis, PMHNP
• Meaghan Petrunic
• Patricia Rose Pettit-Blair
• Morgan Layne Pettit
• Adam Pettitt, PHD
• Elizabeth Petty
• Yvonne Pfaff

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.