ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC
NPI 1356905855
Clinic/Center in Portland, OR
NPI Status: Active since April 30, 2019
Contact Information
4035 SE 52ND AVE STE B
PORTLAND, OR
ZIP 97206
Phone: (503) 482-7556
Fax: (971) 244-9171
- Organization
- Clinic/Center
- Accepts Insurance
About ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC
This page provides the complete NPI Profile along with additional information for Illumination Rock Integrative Medicine, Llc, a provider established in Portland, Oregon operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1356905855 assigned on April 2019. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Illumination Rock Integrative Medicine, Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Kirsten Karen Isakson Lac (Managing Member)
- NPI
- 1356905855
- Provider Name
- ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC
- Entity Type
- Organization
- Location Address
- 4035 SE 52ND AVE STE B PORTLAND, OR 97206
- Location Phone
- (503) 482-7556
- Location Fax
- (971) 244-9171
- Mailing Address
- 4035 SE 52ND AVE STE B PORTLAND, OR 97206
- Mailing Phone
- (971) 229-2140
- Mailing Fax
- (971) 244-9171
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-30-2019
- Last Update Date
- 03-30-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- 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).
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 171100000X | Other Service Providers | Acupuncturist | |
| 2 | 175F00000X | Other Service Providers | Naturopath | |
| 3 | 2081N0008X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | |
| 4 | 2081P2900X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | |
| 5 | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Bronze Essential 8500 With 4 Copay No Deductible Office Visits Individual and Family Network - EPO
- Bronze HSA 7000 Individual and Family Network - EPO
- Gold 2300 Individual and Family Network - EPO
- Regence Standard Bronze Plan Individual and Family Network - EPO
- Regence Standard Gold Plan Individual and Family Network - EPO
- Regence Standard Silver Plan Individual and Family Network - EPO
- Silver 6200 Individual and Family Network - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500703138 | MEDICAID (05) | OR | |
| 1932568458 | OTHER (01) | NPI TYPE 1 |
Reviews for ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 5 | 6 | 9 | 0 | 5 | 8 | 5 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 10 | 6 | 18 | 0 | 10 | 8 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 0 + 6 + 1 + 8 + 0 + 1 + 0 + 8 + 1 + 0 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1356905855 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1467634790 | MS. TRACY LYNN BELK LMT Individual | Massage Therapist | 4035 SE 52ND AVE STE B PORTLAND, OR 97206 (503) 774-4099 |
| 1952885758 | LILA DERICKSON ND Individual | Naturopath | 4035 SE 52ND AVE STE B PORTLAND, OR 97206 (503) 447-7757 |
| 1962161000 | MS. LYDIA DIANE TATE LAC Individual | Acupuncturist | 4035 SE 52ND AVE STE B PORTLAND, OR 97206 (971) 229-2140 |
| 1932568458 | KIRSTEN KAREN ISAKSON LAC Individual | Acupuncturist | 4035 SE 52ND AVE STE B PORTLAND, OR 97206 (971) 229-2140 |
| 1215724059 | BE WELL ACUPUNCTURE Organization | Clinic/Center (Medical Specialty) | 4035 SE 52ND AVE STE B PORTLAND, OR 97206 (917) 843-2256 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356905855, enumerated in the NPI registry as an "organization" on April 30, 2019
The provider is located at 4035 Se 52nd Ave Ste B Portland, Or 97206 and the phone number is (503) 482-7556
This medical organization specializes in Clinic/Center with taxonomy code 261Q00000X
The provider might be accepting Accepts: BridgeSpan Health Company, Regence BlueCross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on April 30, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.