Kathryn Joan Otto, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

15550 Issued in OR

Practice address

3737 N Mississippi Ave
Portland, OR 97227-1158

Phone

(503) 467-4511

Fax

(503) 467-4513

NPI assigned

Apr 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mississippi Chiropractic, P.C.

  • Chiropractor
  • Portland, OR
  • NPI 1841353315
  NPD (past)

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1356585202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 N MISSISSIPPI AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271158",
            "telephone_number": "503-467-4511",
            "fax_number": "503-467-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 N MISSISSIPPI AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271158",
            "telephone_number": "503-467-4511",
            "fax_number": "503-467-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "KATHRYN",
        "middle_name": "JOAN",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "15550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT",
            "identifier": "15550",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reade Otto-Moudry, MD
• Bettricia A Otto, DPM
• Francis Aurora Otto, MA, LPC, RSMT/E
• Heather Rose Otto, PMHNP-BC
• Heidi Louisa Otto, RN, QMHA
• Lesley Nicoloff Otto, MD
• Madeline Otto, MD
• Kaytlin Ottofazi, BCBA
• Casondra Ottowa, RN
• Michael Ouanesisouk

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.