Advanced Alternative Healthcare Clinic, Inc.

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

ADVANCED ALTERNATIVE HEALTHCARE CLINIC, INC.

Practice address

32811 SW Huser LN
Scappoose, OR 97056-2636

Phone

(503) 267-7659

NPI assigned

Oct 9, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Shelby Fagan, LMT

Title

President

Phone

(503) 267-7659

Specialties & licenses 1

Addresses

Other names 1

• Advanced Medical Massage Doing business as

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1013482785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32811 SW HUSER LN",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970562636",
            "telephone_number": "503-267-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32811 SW HUSER LN",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970562636",
            "telephone_number": "503-267-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ALTERNATIVE HEALTHCARE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-09",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-267-7659",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Medical Massage",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Medical Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Scappoose, OR
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.