Active NPI
Elizabeth Mae Evergreen, LMT
- Massage Therapist
- Hillsboro, OR
National Provider Identifier
1124527338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 23876
- Practice address
- 2167 NW 185TH Ave
Hillsboro, OR 97124-7074 - Phone
- (503) 828-1311
- NPI assigned
- Feb 3, 2018
- Last updated
- Feb 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 23876 | OR | Primary |
Addresses
Primary practice location
2167 NW 185TH Ave
Hillsboro, OR 97124-7074
Mailing address
2167 NW 185TH Ave
Hillsboro, OR 97124-7074
Phone (503) 828-1311
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 |
|---|---|---|---|
| 23876 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marcotte Studio One | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517616000000",
"number": "1124527338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2167 NW 185TH AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971247074",
"telephone_number": "503-828-1311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2167 NW 185TH AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971247074",
"telephone_number": "503-828-1311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERGREEN",
"first_name": "ELIZABETH",
"middle_name": "MAE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-03",
"last_updated": "2018-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "23876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
- Laura Elizabeth Evans, P.T.
- Randall Evans, DC
- Dawnielle Everett, LMT
- Evergreen Oregon Healthcare Tualatin LLC (EmpRes Hillsboro Health and Rehabilitation Center)
- Evergreen Prosthetics and Orthotics, LLC
- Everlasting Care LLC
- Tracy Ann Evers-Selleck, REGISTERED NURSE
- Richard James Lawrence Everts
- Daryl B Ewing, DPT
- Eye Health Northwest Optical, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.