Repare Massage LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

8052 Issued in OR

Legal business name

REPARE MASSAGE LLC

Practice address

4004 SW Kelly Ave Ste 203
Portland, OR 97239-4389

Phone

(503) 679-6881

NPI assigned

Jun 7, 2017

Organization subpart

No

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

Authorized official

Name

Leslie June Christiansen, LMTNPI 1134385313

Title

Owner/Provider

Phone

(503) 679-6881

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Leslie J Christiansen, LMT

  • Massage Therapist
  • Portland, OR
  • NPI 1134385313
  NPD Authorized official
• Emilie Cross

  • Massage Therapist
  • Portland, OR
  • NPI 1376920876
  NPD (past)
• Lisa Lotts, L.M.T.

  • Massage Therapist
  • Portland, OR
  • NPI 1295287696
  NPD (past)

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093244642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 SW KELLY AVE STE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394389",
            "telephone_number": "503-679-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 SW KELLY AVE STE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394389",
            "telephone_number": "503-679-6881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7831 SE Stark St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972152301",
            "country_code": "US",
            "telephone_number": "503-679-6881",
            "fax_number": "503-777-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REPARE MASSAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSEN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "503-679-6881",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OR",
            "license": "8052",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SS",
            "identifier": "542966745",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Christine Rentschler, AU.D., CCC-A
• Shannon Marie Rentz, RD, LD
• Stephen Einar Renwick, MD
• Dominique Kristine Renyer, BA
• Julia L Reodica, RN, FNP-C
• Reperio Health Medical Group, PLLC
• Reperio Health, Inc.
• Marilyn Louise Replogle, M.D.
• Kristin Repnik, MOT/OTR/L
• Kayla Repp

• Health Maintenance Organization in Portland, OR
• Providers in Portland, OR by specialty
• Health Maintenance Organization in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.