Lydia Diane Tate, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC208176 Issued in OR

Practice address

4035 SE 52ND Ave Ste B
Portland, OR 97206-3913

Phone

(971) 229-2140

NPI assigned

Dec 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: l.tate@ir-im.org

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1962161000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 SE 52ND AVE STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972063913",
            "telephone_number": "971-229-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 SE 52ND AVE STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972063913",
            "telephone_number": "971-229-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "LYDIA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC208176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "L.tate@ir-im.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4035 SE 52nd Ave Ste B",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972063913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Tate
• Jeanne Renee Tate, PSYD
• Jill Nicole Deymonaz Tate, SLP
• Jody H Tate, MD
• Jonathan Michael Tate, MD
• Mallary-Marie Quinn Tate
• Mollie Christina Tate, RDH
• Rachel Tate, LMT
• Randall Hezekiah Tate
• Sandra Ann Tate, LCSW

• 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 Dec 16, 2021; 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.