Individual provider Active NPI

Tracy Brisbois, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1356153803
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7215 Issued in OR
Practice address
4923 SW Lowell St
Portland, OR 97221-2051
Phone
(503) 515-4086
NPI assigned
Jan 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 7215 OR Primary

Addresses

Primary practice location

4923 SW Lowell St
Portland, OR 97221-2051

Mailing address

4923 SW Lowell St
Portland, OR 97221-2051
Phone (503) 515-4086

Other practice location 1

4475 SW Scholls Ferry Rd Ste 210
Portland, OR 97225-1978
Phone (503) 292-0781

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
7215ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Center of Raleigh Hills PC PastSince Nov 20, 2018 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": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1356153803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 SW LOWELL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212051",
            "telephone_number": "503-515-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 SW LOWELL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212051",
            "telephone_number": "503-515-4086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4475 SW Scholls Ferry Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972251978",
            "country_code": "US",
            "telephone_number": "503-292-0781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRISBOIS",
        "first_name": "TRACY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "7215",
            "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 Jan 22, 2025; 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.