Individual provider Active NPI

Amanda Jane Ashlock, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1306498977
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
19392 Issued in OR
Practice address
407 NW 17TH Ave Ste 5
Portland, OR 97209-2247
Phone
(971) 221-7154
NPI assigned
Jul 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 19392 OR Primary

Addresses

Primary practice location

407 NW 17TH Ave Ste 5
Portland, OR 97209-2247

Mailing address

4927 NE 30TH Ave
Portland, OR 97211-7007
Phone (971) 221-7154

Other practice location 1

4927 NE 30th Ave
Portland, OR 97211-7007
Phone (971) 221-7154

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
19392ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1306498977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4927 NE 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972117007",
            "telephone_number": "971-221-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 NW 17TH AVE STE 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092247",
            "telephone_number": "971-221-7154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4927 NE 30th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972117007",
            "country_code": "US",
            "telephone_number": "971-221-7154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASHLOCK",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19392",
            "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 Jul 12, 2019; 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.