Individual provider Active NPI

Neifa Dolores Alonso, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1104401421
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
24711 Issued in OR
Practice address
12741 NE Halsey St
Portland, OR 97230-2343
Phone
(503) 255-0306
Fax
(503) 257-1452
NPI assigned
Mar 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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 MA61137617 WA
Massage Therapist 225700000X 24711 OR Primary

Addresses

Primary practice location

12741 NE Halsey St
Portland, OR 97230-2343

Mailing address

PO Box 82
Newberg, OR 97132-0082
Phone (971) 200-9105

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
24711ORMDMassage Therapist
MA61137617WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1104401421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971320082",
            "telephone_number": "971-200-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12741 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302343",
            "telephone_number": "503-255-0306",
            "fax_number": "503-257-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONSO",
        "first_name": "NEIFA",
        "middle_name": "DOLORES",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61137617",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24711",
            "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 Feb 2, 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.