Edge Performance Fitness LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

16562 Issued in OR

Legal business name

EDGE PERFORMANCE FITNESS LLC

Practice address

1502 N Ainsworth St
Portland, OR 97217-4706

Phone

(503) 265-8685

NPI assigned

Apr 13, 2010

Organization subpart

No

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

Authorized official

Name

William Amadon

Title

General Manager

Phone

(503) 265-8685

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1285950428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 N AINSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174706",
            "telephone_number": "503-265-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 N AINSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174706",
            "telephone_number": "503-265-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE PERFORMANCE FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "AMADON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "503-265-8685"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "16562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Owen Eden, MD
• Jessica Eden, LMT
• David Tinman Edgar, LCSW
• Scott W Edgar, DMD
• Thomas Edgar, MD
• Kara Edge, MSW
• Patricia Edge, LCSW
• William Alexander Edgell, PA-C
• Deven Edgerton
• Hannah Diane Edgerton, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.