Individual provider Active NPI

Fredy Rubio

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1346977048
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
23677 Issued in OR
Practice address
205 SE Spokane St
Portland, OR 97202-6487
Phone
(971) 772-8322
NPI assigned
Aug 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X 23677 OR Primary

Addresses

Primary practice location

205 SE Spokane St
Portland, OR 97202-6487

Mailing address

205 SE Spokane St
Portland, OR 97202-6487

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
23677ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1346977048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SE SPOKANE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SE SPOKANE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026487",
            "telephone_number": "971-772-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIO",
        "first_name": "FREDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "23677",
            "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 Aug 2, 2022; 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.