Individual provider Active NPI

Christopher Leshawn Elliott-Person

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1235960816
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27671 Issued in OR
Practice address
2100 NE Broadway St Ste 125
Portland, OR 97232-1500
Phone
(503) 477-8222
Fax
(971) 373-8648
NPI assigned
Aug 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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 27671 OR Primary

Addresses

Primary practice location

2100 NE Broadway St Ste 125
Portland, OR 97232-1500

Mailing address

2100 NE Broadway St Ste 125
Portland, OR 97232-1500
Phone (503) 477-8222

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
Credentials
Master of Theology

State licenses

LicenseStateTypeSpecialty
27671ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Haleola Chiropractic Inc CurrentSince Aug 18, 2024 Accepting new patients
Haleola Chiropractic Inc PastSince Aug 18, 2024 Accepting new patients

Locations

2100 NE Broadway St
Ste 125
Portland, OR 97232
Phone (503) 477-8222

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1235960816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 125",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321500",
            "telephone_number": "503-477-8222",
            "fax_number": "971-373-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 125",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321500",
            "telephone_number": "503-477-8222",
            "fax_number": "971-373-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT-PERSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "LESHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "27671",
            "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 Aug 13, 2024; 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.