Molly Elizabeth Thelisdort, N.D., L.AC.

Primary specialty

NaturopathTaxonomy code 175F00000X

License

4073 Issued in OR

Practice address

1110 SE Alder St
St #201
Portland, OR 97214-2400

Phone

(503) 477-5051

Fax

(503) 954-2374

NPI assigned

May 2, 2017

Last updated

May 2, 2017By the provider in NPPES

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

Other names 1

• Molly Elizabeth Langteau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1982130522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7816 SW RUBY TER",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972194644",
            "telephone_number": "214-507-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST",
            "address_2": "ST #201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "503-477-5051",
            "fax_number": "503-954-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELISDORT",
        "first_name": "MOLLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "N.D., L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "LANGTEAU",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandra Thein
• Andria D Theiss, BS
• Divya Thekkethala Winovich, MPH
• Elyssa Thelin
• Isaac Anihili Thelin, PMHNP-BC
• Thelma Jean Mays MD PC
• Thelma Vega LLC
• Jayde Theobald, LMT
• Sarah Theodoroff, PH.D.
• Jennifer Theone

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.