Individual provider Active NPI

Angelica Leeanna Pedraza, LMT

  • Massage Therapist
  • Eugene, OR
National Provider Identifier
1104761352
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
29591 Issued in OR
Practice address
2911 Tennyson Ave Ste 204
Eugene, OR 97408-4393
Phone
(541) 515-6194
Fax
(541) 505-9574
NPI assigned
Apr 22, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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 29591 OR Primary

Addresses

Primary practice location

2911 Tennyson Ave Ste 204
Eugene, OR 97408-4393

Mailing address

2911 Tennyson Ave Ste 204
Eugene, OR 97408-4393
Phone (541) 515-6194

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
29591ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1776816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1104761352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 TENNYSON AVE STE 204",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974084393",
            "telephone_number": "541-515-6194",
            "fax_number": "541-505-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 TENNYSON AVE STE 204",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974084393",
            "telephone_number": "541-515-6194",
            "fax_number": "541-505-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA",
        "first_name": "ANGELICA",
        "middle_name": "LEEANNA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-22",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "29591",
            "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 Apr 22, 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.