Individual provider Active NPI

Tanya Marie Hladik, LMP

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1104105097
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
LMT-25996 Issued in OR
Practice address
1616 SE Ankeny St
Portland, OR 97214-1448
Phone
(360) 393-1708
NPI assigned
Aug 9, 2011
Last updated
May 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X LMT-25996 OR Primary
Doula 374J00000X NU

Addresses

Primary practice location

1616 SE Ankeny St
Portland, OR 97214-1448

Mailing address

1616 SE Ankeny St
Portland, OR 97214-1448
Phone (360) 393-1708

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
LMT-25996ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1104105097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 SE ANKENY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141448",
            "telephone_number": "360-393-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 SE ANKENY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141448",
            "telephone_number": "360-393-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLADIK",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "LMT-25996",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 May 8, 2026; 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.