Shizeng Yang
Individual provider Active NPI Massage Therapist · Estacada, OR
NPI 1265130611 · NPPES record last updated Feb 15, 2023
Key facts
- NPI
- 1265130611
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 5118 (OR)
- Practice address
- 19114 S Springwater Rd
Estacada, OR 97023-8667 - Phone
- (503) 503-7047
- Fax
- (503) 200-1422
- NPI assigned
- Feb 15, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5118 | OR | MD | Sports Physician Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 5118 | OR | Yes |
Addresses
Primary practice location
19114 S Springwater Rd
Estacada, OR 97023-8667
Mailing address
19114 S Springwater Rd
Estacada, OR 97023-8667
Phone (503) 503-7047
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5118 | Other | OR | LMT |
Other providers in Estacada, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.