Active NPI
Equilibria LLC
- Massage Therapist
- Portland, OR
National Provider Identifier
1245497791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 661684
- Legal business name
- EQUILIBRIA LLC
- Doing business as
- Equilibria Massage
- Practice address
- 1536 NW 23Rd Ave
Second Floor
Portland, OR 97210-2618 - Phone
- (503) 221-2155
- Fax
- (503) 274-4159
- NPI assigned
- May 21, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer M Bode, LMT
- Title
- LMT
- Phone
- (503) 221-2155
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 661684 | OR | Primary |
Addresses
Primary practice location
1536 NW 23Rd Ave
Second Floor
Portland, OR 97210-2618
Mailing address
1536 NW 23Rd Ave
Second Floor
Portland, OR 97210-2618
Phone (503) 221-2155
Other names 1
- Equilibria Massage
National Provider Directory
National Provider DirectoryLocations
1536 NW 23rd Ave
Fl Second
Portland, OR 97210
Phone (503) 221-2155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211328000000",
"number": "1245497791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1536 NW 23RD AVE",
"address_2": "SECOND FLOOR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102618",
"telephone_number": "503-221-2155",
"fax_number": "503-274-4159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1536 NW 23RD AVE",
"address_2": "SECOND FLOOR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102618",
"telephone_number": "503-221-2155",
"fax_number": "503-274-4159"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EQUILIBRIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-21",
"last_updated": "2008-05-21",
"status": "A",
"authorized_official_last_name": "BODE",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "LMT",
"authorized_official_telephone_number": "503-221-2155",
"authorized_official_credential": "LMT"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "OR",
"license": "661684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Equilibria Massage",
"code": "3",
"type": "Doing Business As"
}
]
}
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 May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.