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SOURCE INTEGRATIVE MEDICINE LLC
NPI 1275918278
Acupuncturist in Portland, OR

Active since July 21, 2015
4424 NE GLISAN ST, PORTLAND, OR 97213(503) 928-6728(503) 296-5917 Get Directions Write a Review

NPPES record last updated: August 6, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Source Integrative Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOURCE INTEGRATIVE MEDICINE LLC (NPI 1275918278) is a healthcare organization registered as an acupuncturist in Portland, Oregon and active in the NPI registry since July 2015. The organization lists Dara Cantor, Owner, as its authorized official.

NPPES Registry Identity

NPI1275918278
Entity TypeOrganization
Primary Taxonomy171100000X
Legal Business NameSOURCE INTEGRATIVE MEDICINE LLC
Location Address4424 NE GLISAN STPortland, OR 97213-2331
Mailing Address4424 Ne Glisan StPortland, OR 97213-2331 · (503) 928-6728 · Fax (503) 296-5917
Phone(503) 928-6728
Fax(503) 296-5917
Organization SubpartNo
Authorized OfficialDara CantorOwner · (503) 928-6728
Enumeration DateJuly 21, 2015
Last NPPES UpdateAugust 6, 2015
✔ NPI 1275918278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAcupuncturistOther Service Providers
Taxonomy Code171100000X
License✔ Licensed in OR · AC165411
Definition
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
4424 NE GLISAN ST, Portland, OR 97213
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER WEISS L.M.T.
Massage Therapist
4424 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 473-2914
MR. BENJAMIN LEO MARX L.AC.
Acupuncturist
4424 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 928-6728
BEAR HEART INTEGRATED BODYWORK LLC
Clinic/Center
4424 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (971) 344-3648
MRS. SARA SENTELL N.D., L.AC.
Naturopath
4424 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 477-5167
THE REN CLINIC
Clinic/Center (Health Service)
4424 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 805-7131
SIGNE RUTH POQUETTE ND
Naturopath
4424 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 477-5167
ABBY LEE MCHALE
Massage Therapist
4424 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 360-6953
GRANT DONNELL PARTRIDGE M.F.T.
Marriage & Family Therapist
4424 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 455-4016

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Source Integrative Medicine LLC's NPI number?

The NPI number for Source Integrative Medicine LLC is 1275918278. It was assigned to this organization in the NPPES registry on July 21, 2015.

Where is Source Integrative Medicine LLC located?

Source Integrative Medicine LLC is located at 4424 NE Glisan St, Portland, OR 97213. The listed phone number is (503) 928-6728.

What is Source Integrative Medicine LLC's specialty?

The primary specialty registered for this NPI is Acupuncturist with taxonomy code 171100000X.

When was this NPI record last updated?

The NPPES record for Source Integrative Medicine LLC was last updated on August 6, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.