Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Source Integrative Medicine LLC

Organization Acupuncturist · NPI 1275918278

Source Integrative Medicine LLC is an Acupuncturist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2015.

Licensed in
OR
In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4424 NE Glisan St
Portland, OR 97213-2331
Phone: (503) 928-6728
Fax: (503) 296-5917
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acupuncturist (primary) Taxonomy 171100000X · Licence AC165411 (OR)

Record details

NPI number1275918278
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dara Cantor — Owner · (503) 928-6728
NPI enumeratedJuly 21, 2015
Last updated in NPPESAugust 6, 2015
Mailing address4424 Ne Glisan St, Portland, OR 97213-2331

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