NPIMap

Individual provider Active NPI

Maria R Varesio, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1033401393
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
17597 Issued in OR
Practice address
833 SE Main St
428
Portland, OR 97214-3454
Phone
(503) 477-2857
NPI assigned
May 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 17597 OR Primary

Addresses

Primary practice location

833 SE Main St
428
Portland, OR 97214-3454

Mailing address

12570 SE 105TH Ave
Clackamas, OR 97015-6728

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

LicenseStateTypeSpecialty
17597ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Balance Bodywork LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1033401393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12570 SE 105TH AVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SE MAIN ST",
            "address_2": "428",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143454",
            "telephone_number": "503-477-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARESIO",
        "first_name": "MARIA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17597",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 5, 2011; 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.