Beaverton Massage Studio

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

BEAVERTON MASSAGE STUDIO

Practice address

14631 SW Millikan Way Ste 11
Beaverton, OR 97003-2999

Phone

(503) 754-7949

Fax

(503) 662-6115

NPI assigned

Mar 29, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Mallory Corrin Lawvor, LMTNPI 1770948408

Title

Owner

Phone

(503) 332-4347

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mallory Corrin Lawvor, LMT

  • Massage Therapist
  • Beaverton, OR
  • NPI 1770948408
  NPD (past) Authorized official

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

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585440000000",
    "number": "1265060966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14631 SW MILLIKAN WAY STE 11",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970032999",
            "telephone_number": "503-754-7949",
            "fax_number": "503-662-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14631 SW MILLIKAN WAY STE 11",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970032999",
            "telephone_number": "503-754-7949",
            "fax_number": "503-662-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVERTON MASSAGE STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-29",
        "last_updated": "2020-03-29",
        "certification_date": "2020-03-29",
        "status": "A",
        "authorized_official_last_name": "LAWVOR",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "CORRIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-332-4347",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2020; 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.