MR. CHARLES LEROY WILK (NPI# 1174771703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174771703 |
| Entity Type | Individual |
| Full Name | MR. CHARLES LEROY WILK |
| Credential | L.AC. |
| Practice Address |
4511 Se Hawthorne Blvd Suite 214 Portland OR 97215-3170 |
| Practice Telephone | 5032410042 |
| Mailing Telephone | 5032410042 |
| Mailing Fax Number | 5032410052 |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2013-08-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171100000X | Acupuncturist | AC00212 | OR | Other Service Providers |
| Street Address |
4511 SE HAWTHORNE BLVD SUITE 214 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97215-3170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932104825 | Jonna Elizabeth Hongo | Dentist | 4511 Se Hawthorne Blvd, Ste 110, Portland, OR 97215-3170 | 2005-06-16 |
| 1083154637 | Mindful Awakenings, LLC | Community/Behavioral Health | 4511 Se Hawthorne Blvd, Suite 204, Portland, OR 97215-3182 | 2017-03-01 |
| 1306394663 | Lauren Deisenroth Pmhnp-bc LLC | Clinic/Center | 4511 Se Hawthorne Blvd, Suite 215, Portland, OR 97215-3170 | 2016-09-15 |
| 1689065864 | Elin Katrina Allen | Dental Hygienist | 4511 Se Hawthorne Blvd, Ste 101, Portland, OR 97215-3170 | 2015-02-10 |
| 1881025872 | Travis Jonquil | Massage Therapist | 4511 Se Hawthorne Blvd, Suite 204, Portland, OR 97215-3170 | 2013-12-02 |
| 1669759767 | Heritage Dental | Clinic/Center | 4511 Se Hawthorne Blvd, Suite 101, Portland, OR 97215-3195 | 2011-11-03 |
| 1336434703 | Dr. Jonna E. Hongo | Clinic/Center | 4511 Se Hawthorne Blvd, Suite 110, Portland, OR 97215-3170 | 2011-06-14 |
| 1770886939 | Karina Marie Jarvela | Naturopath | 4511 Se Hawthorne Blvd, Suite 208, Portland, OR 97215 | 2010-12-09 |
| 1518106319 | Richard Justin Tooke | Dentist | 4511 Se Hawthorne Blvd, Portland, OR 97215-3170 | 2009-02-18 |
| 1114194818 | Hawthorne Dental | Dentist | 4511 Se Hawthorne Blvd, Ste 205, Portland, OR 97215-3170 | 2008-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
| 1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
| 1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
| 1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
| 1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
| 1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
| 1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
| 1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
| 1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
| 1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
| Find all providers in zip 97215 | ||||
| Taxonomy Code | 171100000X |
| Grouping | Other Service Providers |
| Classification | Acupuncturist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073490 | Krista Marie Obenlock | Acupuncturist | 2408 N Baldwin St, Portland, OR 97217-6404 | 2020-11-06 |
| 1841897550 | Woven Wellness LLC | Acupuncturist | 6511 N Interstate Ave, Portland, OR 97217-4835 | 2020-10-06 |
| 1518571322 | Charisse Renee Squires | Acupuncturist | 1804 Se Oak St, Portland, OR 97214-1538 | 2020-08-31 |
| 1659989069 | Touchet Acupuncture | Acupuncturist | 4605 Ne Fremont St Ste 204a, Portland, OR 97213-1715 | 2020-07-22 |
| 1417571480 | Dragon Rises Center for Wholeness | Acupuncturist | 4852 Sw Scholls Ferry Rd, Portland, OR 97225-1698 | 2020-06-04 |
| 1972126191 | Acupuncture By Maya Martinez LLC | Acupuncturist | 12732 Se Stark St Bldg G, Portland, OR 97233-1539 | 2020-05-21 |
| 1437771854 | Hannah Grice | Acupuncturist | 11750 Sw Barnes Rd Ste 240, Portland, OR 97225-5911 | 2020-05-07 |
| 1164043022 | Michelle Yan | Acupuncturist | 2855 Nw Thurman St, Portland, OR 97210-2206 | 2020-05-01 |
| 1174144562 | Dean Mcnash | Acupuncturist | 2222 Se Woodward St, Portland, OR 97202-2157 | 2020-04-27 |
| 1205456548 | Zev J Alpert | Acupuncturist | 3150 Sw Bertha Blvd Apt 11, Portland, OR 97239-1181 | 2020-04-16 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.