Individual provider Active NPI

Zachary Diamond, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1154075521
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
24249 Issued in OR
Practice address
3125 E Burnside St
Portland, OR 97214-2073
Phone
(503) 758-9760
Fax
(971) 340-4494
NPI assigned
Feb 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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 24249 OR Primary

Addresses

Primary practice location

3125 E Burnside St
Portland, OR 97214-2073

Mailing address

3125 E Burnside St
Portland, OR 97214-2073

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
24249ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mandala Medicine Acupuncture LLC CurrentSince Feb 6, 2022 Accepting new patients
Evolve Wellness PastSince Feb 6, 2022 Accepting new patients

Locations

3125 E Burnside St
Portland, OR 97214
Phone (503) 272-1841

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1154075521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142073",
            "telephone_number": "503-758-9760",
            "fax_number": "971-340-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "ZACHARY",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24249",
            "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 4, 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.