Individual provider Active NPI

Amy Colleen Wolf, L.AC.

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1942442629
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01035 Issued in OR
Practice address
114 N Killingsworth St
Portland, OR 97217-2435
Phone
(503) 281-4656
Fax
(503) 288-3289
NPI assigned
Mar 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC01035 OR Primary

Addresses

Primary practice location

114 N Killingsworth St
Portland, OR 97217-2435

Mailing address

114 N Killingsworth St
Portland, OR 97217-2435
Phone (503) 281-4656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC01035ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1942442629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172435",
            "telephone_number": "503-281-4656",
            "fax_number": "503-288-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172435",
            "telephone_number": "503-281-4656",
            "fax_number": "503-288-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "AMY",
        "middle_name": "COLLEEN",
        "name_prefix": "Ms.",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01035",
            "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 Mar 27, 2009; 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.