Organization Active NPI

Body Craft Wellness LLC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1922744705
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
BODY CRAFT WELLNESS LLC
Practice address
1135 SE Salmon St.
Suite 108
Portland, OR 97214
Phone
(503) 349-6221
Fax
(503) 907-9117
NPI assigned
May 5, 2022
Organization subpart
Yes
Parent organization
BODY CRAFT WELLNESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Hayley SimonNPI 1962865485
Title
Owner/Provider
Phone
(503) 349-6221

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

1135 SE Salmon St.
Suite 108
Portland, OR 97214

Mailing address

1135 SE Salmon St.
Suite 108
Portland, OR 97214
Phone (503) 349-6221

Other identifiers 1

IdentifierTypeStateIssuer
500783369MedicaidOR

Other names 1

  • Body Craft Wellness Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.faxage.com/main.php

National Provider Directory

National Provider Directory
Part of
Body Craft Wellness LLC

Locations

1135 SE Salmon St
Ste 108
Portland, OR 97214
Phone (503) 349-6221

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": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1922744705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 SE SALMON ST.",
            "address_2": "SUITE 108",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "503-349-6221",
            "fax_number": "503-907-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 SE SALMON ST.",
            "address_2": "SUITE 108",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "503-349-6221",
            "fax_number": "503-907-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY CRAFT WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BODY CRAFT WELLNESS LLC",
        "enumeration_date": "2022-05-05",
        "last_updated": "2025-08-20",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "503-349-6221"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500783369",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.faxage.com/main.php",
            "affiliation": "N",
            "address_1": "1135 SE Salmon St Ste 108",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972142695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Body Craft Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Body Craft Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 20, 2025; 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.