Individual provider Active NPI

Sandra Susan Hyatt

  • Massage Therapist
  • Sherwood, OR
National Provider Identifier
1255699310
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
6530715 Issued in OR
Practice address
16078 SW Tualatin Sherwood Rd
Sherwood, OR 97140-8522
Phone
(503) 625-0100
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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 6530715 OR Primary

Addresses

Primary practice location

16078 SW Tualatin Sherwood Rd
Sherwood, OR 97140-8522

Mailing address

16078 SW Tualatin Sherwood Rd
Sherwood, OR 97140-8522
Phone (503) 625-0100

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
6530715ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1255699310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16078 SW TUALATIN SHERWOOD RD",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971408522",
            "telephone_number": "503-625-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16078 SW TUALATIN SHERWOOD RD",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971408522",
            "telephone_number": "503-625-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYATT",
        "first_name": "SANDRA",
        "middle_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "6530715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.