Individual provider Active NPI

Borys Leonidovych Smolyansky, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1285209767
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
23748 Issued in OR
Practice address
17221 SE Division St
Portland, OR 97236-1240
Phone
(503) 760-0778
NPI assigned
May 26, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

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 23748 OR Primary

Addresses

Primary practice location

17221 SE Division St
Portland, OR 97236-1240

Mailing address

11927 NE 30TH Cir
Vancouver, WA 98682-7714
Phone (503) 819-4529

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
23748ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Interstate Medical Group LLC Massage Therapist CurrentSince Aug 28, 2022 Accepting new patients
J Albing DC LLC PastSince Jun 22, 2021 Accepting new patients

Locations

17221 SE Division St
Portland, OR 97236
Phone (503) 760-0778

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1285209767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11927 NE 30TH CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827714",
            "telephone_number": "503-819-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17221 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972361240",
            "telephone_number": "503-760-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLYANSKY",
        "first_name": "BORYS",
        "middle_name": "LEONIDOVYCH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "23748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 26, 2021; 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.