Active NPI
Gary Leroy Wass, LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1023221728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00016138
- Practice address
- 2929 SW Multnomah Blvd Ste 207
Portland, OR 97219-4072 - Phone
- (509) 240-6989
- NPI assigned
- May 8, 2007
- Last updated
- Dec 8, 2014
- Sex
- Male
- 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 | MA00016138 | WA | Primary |
Addresses
Primary practice location
2929 SW Multnomah Blvd Ste 207
Portland, OR 97219-4072
Mailing address
2929 SW Multnomah Blvd Ste 207
Portland, OR 97219-4072
Phone (509) 240-6989
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5633 | Other | OR | OREGON STATE LISCENCE |
| MA00016138 | Other | WA | STATE LISCENCE NUMBER |
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 |
|---|---|---|---|
| MA00016138 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gary L. Wass | Massage Therapist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417996800000",
"number": "1023221728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 SW MULTNOMAH BLVD STE 207",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972194072",
"telephone_number": "509-240-6989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 SW MULTNOMAH BLVD STE 207",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972194072",
"telephone_number": "509-240-6989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASS",
"first_name": "GARY",
"middle_name": "LEROY",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2014-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00016138",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON STATE LISCENCE",
"identifier": "5633",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LISCENCE NUMBER",
"identifier": "MA00016138",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.