Active NPI
Michael Tre Cline Jr., LMT.
- Specialist
- Salem, OR
National Provider Identifier
1043763980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 21385
- Practice address
- 1505 Whitaker Dr SE
#201
Salem, OR 97317-5912 - Phone
- (503) 269-2108
- NPI assigned
- Jul 27, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 21385 | OR | Primary |
Addresses
Primary practice location
1505 Whitaker Dr SE
#201
Salem, OR 97317-5912
Mailing address
1505 Whitaker Dr SE
#201
Salem, OR 97317-5912
Phone (503) 269-2108
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 |
|---|---|---|---|
| 21385 | OR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469577600000",
"number": "1043763980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 WHITAKER DR SE",
"address_2": "#201",
"city": "SALEM",
"state": "OR",
"postal_code": "973175912",
"telephone_number": "503-269-2108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 WHITAKER DR SE",
"address_2": "#201",
"city": "SALEM",
"state": "OR",
"postal_code": "973175912",
"telephone_number": "503-269-2108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLINE",
"first_name": "MICHAEL",
"middle_name": "TRE",
"name_suffix": "Jr.",
"credential": "LMT.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-27",
"last_updated": "2016-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "21385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.