ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC
NPI 1356905855
Clinic/Center in Portland, OR

Q: What is Illumination Rock Integrative Medicine, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since April 30, 2019

4035 SE 52ND AVE STE B, PORTLAND, OR 97206(503) 482-7556(971) 244-9171 Get Directions Write a Review

NPPES record last updated: March 30, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Illumination Rock Integrative Medicine, Llc NPPES

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

ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC (NPI 1356905855) is a healthcare organization registered as a clinic/center in Portland, Oregon and active in the NPI registry since April 2019. The organization lists Kirsten Karen Isakson, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1356905855

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC

Location Address4035 SE 52ND AVE STE BPortland, OR 97206-3913

Mailing Address4035 Se 52nd Ave Ste BPortland, OR 97206-3913 · (971) 229-2140 · Fax (971) 244-9171

Phone(503) 482-7556

Fax(971) 244-9171

Organization SubpartNo

Authorized OfficialKirsten Karen IsaksonManaging Member · (971) 229-2140

Enumeration DateApril 30, 2019

Last NPPES UpdateMarch 30, 2022

NPPES CertifiedMarch 30, 2022

✔ NPI 1356905855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Also ListedAcupuncturistTaxonomy 171100000X

Also ListedNaturopathTaxonomy 175F00000X

Also ListedPhysical Medicine & Rehabilitation · Neuromuscular MedicineTaxonomy 2081N0008X

Also ListedPhysical Medicine & Rehabilitation · Pain MedicineTaxonomy 2081P2900X

Also ListedMassage TherapistTaxonomy 225700000X

4035 SE 52ND AVE STE B, Portland, OR 97206

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Other Identifiers 2

Medicaid500703138OR

Other1932568458Npi Type 1

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

Other Providers at the Same Location NPPES 7

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

LILAC FAMILY CARE

Acupuncturist