Jessica Cabac

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

21750 Issued in OR

Practice address

1304 NW Civic Dr
Gresham, OR 97030-5569

Phone

(503) 512-1040

NPI assigned

Feb 4, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jessica Cabac Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1003274010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14351 SE SUMMERFIELD WAY",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970865895",
            "telephone_number": "503-507-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 NW CIVIC DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305569",
            "telephone_number": "503-512-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABAC",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "21750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CABAC",
            "prefix": "MRS.",
            "credential": "LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Massage Therapist in Gresham, OR
• Providers in Gresham, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.