Active NPI
Jackie Ankerson
- Massage Therapist
- Astoria, OR
National Provider Identifier
1023518115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 22488
- Practice address
- 1490 Commercial St Ste 202
Astoria, OR 97103-3800 - Phone
- (503) 806-5174
- NPI assigned
- Feb 15, 2018
- Last updated
- Feb 15, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 22488 | OR | Primary |
Addresses
Primary practice location
1490 Commercial St Ste 202
Astoria, OR 97103-3800
Mailing address
1490 Commercial St Ste 202
Astoria, OR 97103-3800
Phone (503) 806-5174
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 |
|---|---|---|---|
| 22488 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Watershed Community Wellness LLC | 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": "1518652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518652800000",
"number": "1023518115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1490 COMMERCIAL ST STE 202",
"city": "ASTORIA",
"state": "OR",
"postal_code": "971033800",
"telephone_number": "503-806-5174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1490 COMMERCIAL ST STE 202",
"city": "ASTORIA",
"state": "OR",
"postal_code": "971033800",
"telephone_number": "503-806-5174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANKERSON",
"first_name": "JACKIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-15",
"last_updated": "2018-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "22488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.