Wintry Verraneault

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

21188 Issued in OR

Practice address

221 SE 11TH Ave Unit 226
Portland, OR 97214-1357

Phone

(971) 279-4454

NPI assigned

Jun 16, 2015

Last updated

Feb 19, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1235510132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4072 NE 10TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121223",
            "telephone_number": "503-333-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 SE 11TH AVE UNIT 226",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141357",
            "telephone_number": "971-279-4454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 SE 41st Ave Apt B",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972145247",
            "country_code": "US",
            "telephone_number": "503-333-3882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERRANEAULT",
        "first_name": "WINTRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "21188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 19, 2019; 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.