Active NPI
Jittra Boonnim, LMT
- Massage Therapist
- Tigard, OR
National Provider Identifier
1013614197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 27324
- Practice address
- 9600 SW Oak St Ste 410
Tigard, OR 97223-6581 - Phone
- (503) 308-8676
- NPI assigned
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 27324 | OR | Primary |
Addresses
Primary practice location
9600 SW Oak St Ste 410
Tigard, OR 97223-6581
Mailing address
1930 S River Dr Unit 306
Portland, OR 97201-8054
Phone (971) 222-9600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27324 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ikigai Wellness LLC | Massage Therapist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767312000000",
"number": "1013614197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 S RIVER DR UNIT 306",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972018054",
"telephone_number": "971-222-9600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 SW OAK ST STE 410",
"city": "TIGARD",
"state": "OR",
"postal_code": "972236581",
"telephone_number": "503-308-8676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOONNIM",
"first_name": "JITTRA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2026-01-02",
"certification_date": "2026-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "27324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.