Active NPI
Phoenix Greenman, LMT
- Mechanotherapist
- Portland, OR
National Provider Identifier
1073744967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 15823
- Practice address
- 3327 SE Hawthorne Blvd
Portland, OR 97214-5046 - Phone
- (503) 577-5512
- NPI assigned
- Jul 27, 2009
- 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 15823 | OR | Primary |
Addresses
Primary practice location
3327 SE Hawthorne Blvd
Portland, OR 97214-5046
Mailing address
836 NE 78TH Ave
Portland, OR 97213-6957
Phone (503) 577-5512
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 |
|---|---|---|---|
| 15823 | OR | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248652800000",
"number": "1073744967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "836 NE 78TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972136957",
"telephone_number": "503-577-5512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3327 SE HAWTHORNE BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972145046",
"telephone_number": "503-577-5512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENMAN",
"first_name": "PHOENIX",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-27",
"last_updated": "2009-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "OR",
"license": "15823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.