Lake Grove Wellness

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

6748 Issued in OR

Legal business name

LAKE GROVE WELLNESS

Practice address

16320 Bryant Rd
Lake Oswego, OR 97035-4308

Phone

(503) 908-1180

NPI assigned

Jun 2, 2014

Organization subpart

No

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

Authorized official

Name

Kathleeen Jordan, LMT

Title

Owner

Phone

(503) 908-1180

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Kelly Megan Butterfield

  • Massage Therapist
  • Lake Oswego, OR
  • NPI 1356934640
  NPD (past)
• Kathleen Jordan, LMT

  • Massage Therapist
  • Lake Oswego, OR
  • NPI 1154733624
  NPD (past)
• Shawna Day Kauffman, LMT

  • Massage Therapist
  • Tualatin, OR
  • NPI 1942795737
  NPD (past)

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1053723536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16320 BRYANT RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354308",
            "telephone_number": "503-908-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16320 BRYANT RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354308",
            "telephone_number": "503-908-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE GROVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "KATHLEEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-908-1180",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "6748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Arlene Lajoy, LCSW
• Lake Grove Chiropractic, PC
• Lake Grove Dental
• Lake Grove ENT PC
• Lake Grove Family Medical Clinic LLC
• Lake Medical Clinic, Inc.
• Lake Oswego Chiropractic Clinic, P.C.
• Lake Oswego Dermatology Group, PC
• Lake Oswego Family Physicians
• Lake Oswego Foot Clinic

• Massage Therapist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.