Individual provider Active NPI

Reyna Kohl, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1356208581
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
24769 Issued in OR
Practice address
2632 SE 25TH Ave Ste G
Portland, OR 97202-1285
Phone
(512) 809-3498
NPI assigned
Jan 8, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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 SINGLE SPECIALTY GROUP 225700000X 24769 OR Primary

Addresses

Primary practice location

2632 SE 25TH Ave Ste G
Portland, OR 97202-1285

Mailing address

4607 SE 43Rd Ave
Portland, OR 97206-4103
Phone (512) 809-3498

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
24769ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Foliage Massage & Botanicals LLC Single Specialty Current Accepting new patients

Locations

2632 SE 25th Ave
Ste G
Portland, OR 97202
Phone (510) 541-2031

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": "1767830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1356208581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 SE 43RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064103",
            "telephone_number": "512-809-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 SE 25TH AVE STE G",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021285",
            "telephone_number": "512-809-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHL",
        "first_name": "REYNA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24769",
            "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 8, 2026; 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.