Individual provider Active NPI

Adele R Dela Roaa, LMT

  • Massage Therapist
  • Eagle, ID
National Provider Identifier
1174434484
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MAS-4839 Issued in ID
Practice address
435 E Shore Dr Ste 130
Eagle, ID 83616-5754
Phone
(808) 333-7694
NPI assigned
Sep 15, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X MAS-4839 ID Primary

Addresses

Primary practice location

435 E Shore Dr Ste 130
Eagle, ID 83616-5754

Mailing address

5239 N Ebbetts Ave
Boise, ID 83713-1279
Phone (808) 333-7694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1174434484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5239 N EBBETTS AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131279",
            "telephone_number": "808-333-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 E SHORE DR STE 130",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165754",
            "telephone_number": "808-333-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA ROAA",
        "first_name": "ADELE",
        "middle_name": "R",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS-4839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.