Active NPI
Daniel Edwards
- Massage Therapist
- Beaverton, OR
National Provider Identifier
1073078614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 22660
- Practice address
- 4655 SW Griffith Dr Ste 180
Beaverton, OR 97005-8732 - Phone
- (503) 746-5214
- NPI assigned
- Feb 7, 2019
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 22660 | OR | Primary |
Addresses
Primary practice location
4655 SW Griffith Dr Ste 180
Beaverton, OR 97005-8732
Mailing address
12430 SW Ash Ave Apt 25
Tigard, OR 97223-6237
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 |
|---|---|---|---|
| 22660 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conerstone Chiropractic PS Inc | 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.
-
- Clinic/Center
- Beaverton, OR
- NPI 1609321157
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549497600000",
"number": "1073078614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12430 SW ASH AVE APT 25",
"city": "TIGARD",
"state": "OR",
"postal_code": "972236237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4655 SW GRIFFITH DR STE 180",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970058732",
"telephone_number": "503-746-5214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-07",
"last_updated": "2019-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "22660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.