Courtney V Edwards, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

17628 Issued in OR

Practice address

19365 SW 65TH Ave Ste 104
Tualatin, OR 97062-9196

Phone

(503) 486-5199

Fax

(503) 586-9190

NPI assigned

Oct 10, 2011

Last updated

Oct 10, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9008/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1013291988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19365 SW 65TH AVE STE 104",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629196",
            "telephone_number": "503-486-5199",
            "fax_number": "503-486-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19365 SW 65TH AVE STE 104",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629196",
            "telephone_number": "503-486-5199",
            "fax_number": "503-586-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "COURTNEY",
        "middle_name": "V",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.