Active NPI
Steve J Davis, RYT, LMT, NCTMB
- Specialist
- Lake Oswego, OR
National Provider Identifier
1124359088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 13099
- Practice address
- 5 Centerpointe Dr
Suite 400
Lake Oswego, OR 97035-8651 - Phone
- (503) 724-2755
- NPI assigned
- Jan 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 13099 | OR | Primary |
| Health Educator | 174H00000X | YA#29243 | VA | |
| Specialist | 174400000X | 512195-6 | OR |
Addresses
Primary practice location
5 Centerpointe Dr
Suite 400
Lake Oswego, OR 97035-8651
Mailing address
PO Box 1221
Lake Oswego, OR 97035-0518
Phone (503) 724-2755
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13099 | Other | OR | OREGON BOARD OF MASSAGE THERAPISTS |
| 512195-6 | Other | OR | NATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE AND BODYWORK |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13099 | OR | MD | Specialist |
| 512195-6 | OR | MD | Specialist |
| YA#29243 | VA | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1124359088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1221",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970350518",
"telephone_number": "503-724-2755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 CENTERPOINTE DR",
"address_2": "SUITE 400",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970358651",
"telephone_number": "503-724-2755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "STEVE",
"middle_name": "J",
"credential": "RYT, LMT, NCTMB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-15",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "13099",
"primary": true
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "VA",
"license": "YA#29243",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "512195-6",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON BOARD OF MASSAGE THERAPISTS",
"identifier": "13099",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE AND BODYWORK",
"identifier": "512195-6",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.