Mackenna Rae Mastrud, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC209770 Issued in OR

Practice address

2939 SW Spring Garden St
Portland, OR 97219-3946

Phone

(971) 350-9148

NPI assigned

Mar 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1972243749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2939 SW SPRING GARDEN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193946",
            "telephone_number": "971-350-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2939 SW SPRING GARDEN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193946",
            "telephone_number": "971-350-9148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRUD",
        "first_name": "MACKENNA",
        "middle_name": "RAE",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC209770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Masterson
• Rachael Masterson, PA-C
• Brittany Mastin, D.O.
• Mark W Mastrandrea, MD
• John Guy Mastronarde, MD
• Garrett Masuda, DDS, MS
• Connie Lei Masuoka, D.M.D.
• Emeliana Tauanuu Mata
• Brandon L. Matacic, PHARMD
• Gabriela Elena Matamoros Pinto, MD

• 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 Mar 30, 2022; 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.