NPIMap

Organization Active NPI

Integrative Wellness Center, LLC

  • Pain Clinic/Center
  • Portland, OR
National Provider Identifier
1861650301
Registry record updated May 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
AC00850 Issued in OR
Legal business name
INTEGRATIVE WELLNESS CENTER, LLC
Practice address
2343 SE 44TH Ave
Portland, OR 97215-3721
Phone
(503) 997-7181
NPI assigned
May 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2008

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

Authorized official

Name
Richard Brad McConnell, LACNPI 1255538807
Title
Licensed Acupunturist
Phone
(503) 997-7181

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X AC00850 OR Primary

Addresses

Primary practice location

2343 SE 44TH Ave
Portland, OR 97215-3721

Mailing address

2343 SE 44TH Ave
Portland, OR 97215-3721

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212192000000",
    "number": "1861650301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2343 SE 44TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2343 SE 44TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153721",
            "telephone_number": "503-997-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-31",
        "last_updated": "2008-05-31",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "BRAD",
        "authorized_official_title_or_position": "LICENSED ACUPUNTURIST",
        "authorized_official_telephone_number": "503-997-7181",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "OR",
            "license": "AC00850",
            "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 May 31, 2008; 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.