NPIMap

Organization Active NPI

Custom Massage Builders

  • Massage Therapist
  • Corvallis, OR
National Provider Identifier
1154854834
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
17412 Issued in OR
Legal business name
CUSTOM MASSAGE BUILDERS
Practice address
2312 NW Kings Blvd
Corvallis, OR 97330-3925
Phone
(541) 231-2314
NPI assigned
Apr 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Donald Bataglia, LMT
Title
Owner
Phone
(541) 231-2314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 17412 OR Primary

Addresses

Primary practice location

2312 NW Kings Blvd
Corvallis, OR 97330-3925

Mailing address

2312 NW Kings Blvd
Corvallis, OR 97330-3925
Phone (541) 231-2314

National Provider Directory

National Provider Directory
Tax ID family
Boulder Therapuetics4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2312 NW Kings Blvd
Corvallis, OR 97330
Phone (541) 231-2314

NPI Registry JSON

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1154854834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303925",
            "telephone_number": "541-231-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303925",
            "telephone_number": "541-231-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM MASSAGE BUILDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "BATAGLIA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-231-2314",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.