Active NPI
Brodie Nicholas Shinn, LMT
- Massage Therapist
- Hillsboro, OR
National Provider Identifier
1033836150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 25773
- Practice address
- 2167 NW 185TH Ave
Hillsboro, OR 97124-7074 - Phone
- (503) 420-6467
- NPI assigned
- Oct 20, 2022
- Sex
- Male
- 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 | 25773 | OR | Primary |
Addresses
Primary practice location
2167 NW 185TH Ave
Hillsboro, OR 97124-7074
Mailing address
12224 NW Barnes Rd Apt 107
Portland, OR 97229-5956
Phone (503) 420-6467
Other practice location 1
3314 S Kelly Ave
Portland, OR 97239-4628
Phone (503) 420-6467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25773 | Other | OR | EAST WEST SCHOOL OF NATURAL HEALING |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | BrodieshinnLMT@gmail.com | Direct |
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 |
|---|---|---|---|
| 25773 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666224000000",
"number": "1033836150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12224 NW BARNES RD APT 107",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972295956",
"telephone_number": "503-420-6467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2167 NW 185TH AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971247074",
"telephone_number": "503-420-6467"
}
],
"practiceLocations": [
{
"address_1": "3314 S Kelly Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972394628",
"country_code": "US",
"telephone_number": "503-420-6467",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHINN",
"first_name": "BRODIE",
"middle_name": "NICHOLAS",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-20",
"last_updated": "2022-10-20",
"certification_date": "2022-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "25773",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EAST WEST SCHOOL OF NATURAL HEALING",
"identifier": "25773",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "BrodieshinnLMT@gmail.com",
"affiliation": "N",
"endpointDescription": "Business email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2167 NW 185th Ave",
"city": "Hillsboro",
"state": "OR",
"country_code": "US",
"postal_code": "971247074",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.