Active NPI
Adele R Dela Roaa, LMT
- Massage Therapist
- Eagle, ID
National Provider Identifier
1174434484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAS-4839
- 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
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 | 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.