Active NPI
Tamara Lynn Serhan, L.M.T
- Massage Therapist
- Gresham, OR
National Provider Identifier
1275788820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 10403
- Practice address
- 50 NW 2ND St
Gresham, OR 97030-7222 - Phone
- (503) 492-4749
- NPI assigned
- Nov 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 10403 | OR | Primary |
Addresses
Primary practice location
50 NW 2ND St
Gresham, OR 97030-7222
Mailing address
23535 SE Blue Ridge Dr
Damascus, OR 97089-8204
Phone (503) 997-7235
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10403 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227484800000",
"number": "1275788820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23535 SE BLUE RIDGE DR",
"city": "DAMASCUS",
"state": "OR",
"postal_code": "970898204",
"telephone_number": "503-997-7235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 NW 2ND ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307222",
"telephone_number": "503-492-4749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERHAN",
"first_name": "TAMARA",
"middle_name": "LYNN",
"name_prefix": "Miss",
"credential": "L.M.T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-24",
"last_updated": "2008-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "10403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.