OrganizationActive
Source Integrative Medicine LLC
NPI 1275918278 · Acupuncturist · Portland, OR
Source Integrative Medicine LLC is a Acupuncturist organization in Portland, OR (NPI 1275918278).
Provider details
- NPI number
- 1275918278
- Entity type
- Organization
- Primary specialty
- AcupuncturistOther Service Providers
- Organization subpart
- No
- Authorized official
- Dara Cantor, Owner(503) 928-6728
- License
- AC165411 (OR)
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4424 Ne Glisan St
Portland, OR 97213-2331
Phone: (503) 928-6728
Fax: (503) 296-5917
Street-level locationGet directions
Mailing address
4424 Ne Glisan St
Portland, OR 97213-2331
Registry dates
- Enumerated
- 2015-07-21
- Last updated
- 2015-08-06
Frequently asked questions
- What is Source Integrative Medicine LLC's NPI number?
- Source Integrative Medicine LLC's National Provider Identifier (NPI) is 1275918278, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Source Integrative Medicine LLC?
- Source Integrative Medicine LLC is classified in the NPPES registry as Acupuncturist (Other Service Providers).
- Where is Source Integrative Medicine LLC located?
- Source Integrative Medicine LLC's practice location on file with NPPES is 4424 Ne Glisan St, Portland, OR 97213-2331.
- What is Source Integrative Medicine LLC's phone number?
- The practice phone number listed in the NPPES registry for Source Integrative Medicine LLC is (503) 928-6728.
- Who is the authorized official for Source Integrative Medicine LLC?
- The authorized official listed on Source Integrative Medicine LLC's NPPES record is Dara Cantor, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Source Integrative Medicine LLC's NPI active?
- Yes — Source Integrative Medicine LLC's NPI (1275918278) is active in the NPPES registry as of the last update on 2015-08-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.