Individual provider Active NPI

Stacey Guggino, ND, LAC

  • Naturopath
  • Portland, OR
National Provider Identifier
1982902425
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
ND1822 Issued in OR
Practice address
1427 NW Flanders St Ste a
Portland, OR 97209-2646
Phone
(503) 972-0235
NPI assigned
Mar 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC157485 OR
Naturopath 175F00000X ND1822 OR Primary

Addresses

Primary practice location

1427 NW Flanders St Ste a
Portland, OR 97209-2646

Mailing address

2459 SE Tualatin Valley Hwy
Suite 416
Hillsboro, OR 97123-1247
Phone (503) 972-0235

Other practice location 1

728 Molalla Ave
Oregon City, OR 97045-2799
Phone (503) 656-9030

Other identifiers 1

IdentifierTypeStateIssuer
500645662MedicaidOR

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
AC157485ORMDAcupuncturist
ND1822ORMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1982902425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2459 SE TUALATIN VALLEY HWY",
            "address_2": "SUITE 416",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971231247",
            "telephone_number": "503-972-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 NW FLANDERS ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092646",
            "telephone_number": "503-972-0235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "728 Molalla Ave",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970452799",
            "country_code": "US",
            "telephone_number": "503-656-9030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUGGINO",
        "first_name": "STACEY",
        "credential": "ND, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC157485",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "ND1822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500645662",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.