Red Fern Acupuncture and Wellness

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC177271 Issued in OR

Legal business name

RED FERN ACUPUNCTURE AND WELLNESS

Practice address

516 SE Morrison St
Portland, OR 97214-2327

Phone

(443) 812-2240

NPI assigned

Sep 1, 2016

Organization subpart

No

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

Authorized official

Name

Stephen Jacobsen, LACNPI 1639625114

Title

Acupuncturist

Phone

(443) 812-2240

Specialties & licenses 1

Addresses

Practitioners 1

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

• Stephen Jacobsen, LAC.

  • Acupuncturist
  • Milwaukie, OR
  • NPI 1639625114
  NPD (past) Authorized official

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1942757356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 SE 26TH AVE",
            "address_2": "APT. G22",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972229600",
            "telephone_number": "443-812-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SE MORRISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142327",
            "telephone_number": "443-812-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED FERN ACUPUNCTURE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "443-812-2240",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC177271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• William Todd Redberg
• Melinda White Redburn, MA, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.