Kim Magraw, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

19492 Issued in OR

Practice address

3014 NE Killingsworth St.
Portland, OR 97211

Phone

(503) 449-7631

NPI assigned

Aug 26, 2014

Last updated

Feb 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Concordia Wellness, LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1023520814
  NPD Authorized official

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1225438377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 NE KILLINGSWORTH ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97211",
            "telephone_number": "503-449-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 NE KILLINGSWORTH ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97211",
            "telephone_number": "503-449-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGRAW",
        "first_name": "KIM",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "4194",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendhan David Magnuson
• Brian Magnuson, M.D.
• Luann Kristina Magnuson, LPC
• Kari Magnussen, MS
• Philippe Magown, MDCM, PHD
• Jaime Michele Maguire, PT
• Meghan Leanne Maguire
• Clifford Donald Mah, D.P.M.
• Nathan D Mah, PHARMD
• Vaidehi Mahadev, MD

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.