NPIMap

Individual provider Active NPI

Andre Raymond Laurier Jr., LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1154757664
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
19218 Issued in OR
Practice address
17221 SE Division St
Portland, OR 97236-1240
Phone
(503) 760-0778
NPI assigned
Sep 17, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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 19218 OR Primary

Addresses

Primary practice location

17221 SE Division St
Portland, OR 97236-1240

Mailing address

9885 SW Halite CT
Beaverton, OR 97007-8383
Phone (503) 443-9096

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

Practice roles

OrganizationSpecialtyStatusNew patients
Interstate Medical Group LLC Massage Therapist PastSince Aug 28, 2022 Accepting new patients
J Albing DC LLC Past Accepting new patients

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1154757664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9885 SW HALITE CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970078383",
            "telephone_number": "503-443-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17221 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972361240",
            "telephone_number": "503-760-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURIER",
        "first_name": "ANDRE",
        "middle_name": "RAYMOND",
        "name_suffix": "Jr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19218",
            "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 Sep 17, 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.

Verify at the official NPI Registry.