Concordia Wellness, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

19492 Issued in OR

Legal business name

CONCORDIA WELLNESS, LLC

Practice address

3014 NE Killingsworth St
Portland, OR 97211-6814

Phone

(503) 449-7631

NPI assigned

Nov 1, 2017

Organization subpart

No

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

Authorized official

Name

Kim Magraw, LMTNPI 1225438377

Title

Sole Member

Phone

(503) 449-7631

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kim Magraw, LMT

  • Massage Therapist
  • Portland, OR
  • NPI 1225438377
  NPD Authorized official

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601683200000",
    "number": "1023520814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 NE KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116814",
            "telephone_number": "503-449-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 NE KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116814",
            "telephone_number": "503-449-7631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6138 NE 31st Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972116746",
            "country_code": "US",
            "telephone_number": "503-449-7631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONCORDIA WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-01",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A",
        "authorized_official_last_name": "MAGRAW",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "503-449-7631",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "4194",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "19492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Concepts in Community Living, Inc.
• Daniel Concha
• Carolyn Dolores Concia, NP
• Concinnity Therapy LLC
• Concordia Chiropractic Center LLC
• Margaret Rose Condic
• Allegra Condiotte, MD, MHA
• Laura Egli Condit, RD, CNSD, LD
• Natalie Beth Condon, LMT
• Loretta La Rue Cone, LCSW

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2020; 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.