Active NPI
Melissa Diane Espinoza, LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1285874818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 15954
- Practice address
- 12590 SE Stark St Ste N
Portland, OR 97233-1056 - Phone
- (503) 595-9633
- Fax
- (503) 595-9634
- NPI assigned
- Feb 22, 2009
- 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 | 15954 | OR | Primary |
Addresses
Primary practice location
12590 SE Stark St Ste N
Portland, OR 97233-1056
Mailing address
10125 N Burr Ave
Portland, OR 97203-1715
Phone (503) 890-7559
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 |
|---|---|---|---|
| 15954 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235260800000",
"number": "1285874818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10125 N BURR AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972031715",
"telephone_number": "503-890-7559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12590 SE STARK ST STE N",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331056",
"telephone_number": "503-595-9633",
"fax_number": "503-595-9634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESPINOZA",
"first_name": "MELISSA",
"middle_name": "DIANE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-22",
"last_updated": "2009-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "15954",
"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 Feb 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.