Individual provider Active NPI

Ian Marinov Dobrev, LMT

  • Massage Therapist
  • Eugene, OR
National Provider Identifier
1093283889
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
21428 Issued in OR
Practice address
1508 Willamette St
Eugene, OR 97401-4048
Phone
(541) 343-3150
NPI assigned
Nov 9, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 21428 OR Primary

Addresses

Primary practice location

1508 Willamette St
Eugene, OR 97401-4048

Mailing address

677 Woodleaf LN
Eugene, OR 97405-4052
Phone (541) 729-6330

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

LicenseStateTypeSpecialty
21428ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1093283889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 WOODLEAF LN",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974054052",
            "telephone_number": "541-729-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 WILLAMETTE ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014048",
            "telephone_number": "541-343-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBREV",
        "first_name": "IAN",
        "middle_name": "MARINOV",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-09",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "21428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.