Individual provider Active NPI

Erin Ella Phelan, LMT

  • Mechanotherapist
  • Portland, OR
National Provider Identifier
1306149281
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
17754 Issued in OR
Practice address
17223 SE Division St
Portland, OR 97236-1240
Phone
(503) 760-0778
Fax
(503) 760-0753
NPI assigned
Dec 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 17754 OR Primary

Addresses

Primary practice location

17223 SE Division St
Portland, OR 97236-1240

Mailing address

859 SW 257TH Ave
147
Troutdale, OR 97060-7433
Phone (253) 389-1710

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
17754ORMDMechanotherapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Health Care Center 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.

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1306149281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 SW 257TH AVE",
            "address_2": "147",
            "city": "TROUTDALE",
            "state": "OR",
            "postal_code": "970607433",
            "telephone_number": "253-389-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17223 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972361240",
            "telephone_number": "503-760-0778",
            "fax_number": "503-760-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "ERIN",
        "middle_name": "ELLA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "17754",
            "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 Dec 14, 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.