Individual provider Active NPI

Alan Bruce Coffman, L.AC.

  • Acupuncturist
  • Corvallis, OR
National Provider Identifier
1962600932
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00383 Issued in OR
Practice address
552 SW 3Rd St
Corvallis, OR 97333-4439
Phone
(541) 602-2229
Fax
(541) 752-1228
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00383 OR Primary

Addresses

Primary practice location

552 SW 3Rd St
Corvallis, OR 97333-4439

Mailing address

1434 NW 23Rd St
Corvallis, OR 97330-2406
Phone (541) 752-1228

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
AC00383ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1962600932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 NW 23RD ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302406",
            "telephone_number": "541-752-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 SW 3RD ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334439",
            "telephone_number": "541-602-2229",
            "fax_number": "541-752-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "ALAN",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.