Individual provider Active NPI

Leah Rachelle Valdrow, LMT

  • Specialist
  • Clackamas, OR
National Provider Identifier
1174721245
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
10400 Issued in OR
Practice address
15240 SE 82ND Dr
Clackamas, OR 97015-9606
Phone
(503) 656-5510
Fax
(503) 656-8080
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10400 OR Primary

Addresses

Primary practice location

15240 SE 82ND Dr
Clackamas, OR 97015-9606

Mailing address

8211 SE Iris St
Portland, OR 97267-5386
Phone (503) 490-2909

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
10400ORMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1174721245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8211 SE IRIS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972675386",
            "telephone_number": "503-490-2909",
            "fax_number": "503-656-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15240 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159606",
            "telephone_number": "503-656-5510",
            "fax_number": "503-656-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDROW",
        "first_name": "LEAH",
        "middle_name": "RACHELLE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "10400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.