Individual provider Active NPI

Madison Hubbell, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1215654512
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27065 Issued in OR
Practice address
4160 NE Sandy Blvd Ste 1100
Portland, OR 97212-5336
Phone
(971) 379-2455
NPI assigned
Oct 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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 27065 OR Primary

Addresses

Primary practice location

4160 NE Sandy Blvd Ste 1100
Portland, OR 97212-5336

Mailing address

6710 N Wilbur Ave
Portland, OR 97217-5227
Phone (650) 339-3053

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
27065ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1215654512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 N WILBUR AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972175227",
            "telephone_number": "650-339-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 NE SANDY BLVD STE 1100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125336",
            "telephone_number": "971-379-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBELL",
        "first_name": "MADISON",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "27065",
            "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 Oct 26, 2022; 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.