Active NPI
Dalton Bagley, LMT
- Massage Therapist
- Beaverton, OR
National Provider Identifier
1295154698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 19467
- Practice address
- 14619 SW Teal Blvd
Beaverton, OR 97007-6194 - Phone
- (503) 746-6585
- NPI assigned
- Apr 14, 2014
- Sex
- Male
- Sole proprietor
- No
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 | 19467 | OR | Primary |
Addresses
Primary practice location
14619 SW Teal Blvd
Beaverton, OR 97007-6194
Mailing address
534 Illinois Ave NE
Salem, OR 97301-4632
Phone (503) 991-2154
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 |
|---|---|---|---|
| 19467 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D & J Bodyworks, LLC | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Massage Therapist
- Beaverton, OR
- NPI 1326391822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397433600000",
"number": "1295154698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "534 ILLINOIS AVE NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973014632",
"telephone_number": "503-991-2154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14619 SW TEAL BLVD",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970076194",
"telephone_number": "503-746-6585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGLEY",
"first_name": "DALTON",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-14",
"last_updated": "2014-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "19467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.