Individual provider Active NPI

Emily Jane Bydalek, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1043197866
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
28794 Issued in OR
Practice address
1611 SE Bybee Blvd
Portland, OR 97202-5752
Phone
(971) 279-5638
NPI assigned
Aug 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 28794 OR Primary

Addresses

Primary practice location

1611 SE Bybee Blvd
Portland, OR 97202-5752

Mailing address

7901 SE Powell Blvd Ste B
Portland, OR 97206-2314
Phone (503) 856-4722

Other names 1

  • Emily Green Professional name

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
28794ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ritualuna Wellness LLC Single Specialty CurrentSince Aug 25, 2025 Accepting new patients

Locations

1611 SE Bybee Blvd
Portland, OR 97202
Phone (503) 572-9234

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": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1043197866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 SE POWELL BLVD STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062314",
            "telephone_number": "503-856-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 SE BYBEE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025752",
            "telephone_number": "971-279-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYDALEK",
        "first_name": "EMILY",
        "middle_name": "JANE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "28794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "GREEN",
            "credential": "LMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Aug 21, 2025; 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.