Active NPI
Joseph Thomas Stovall II, ESQ., LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1366143372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 27341
- Practice address
- 4313 NE Tillamook St
Portland, OR 97213-1315 - Phone
- (971) 207-3419
- NPI assigned
- Mar 15, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 27341 | OR | Primary |
Addresses
Primary practice location
4313 NE Tillamook St
Portland, OR 97213-1315
Mailing address
14900 S Stevens Rd
Oregon City, OR 97045-8438
Phone (301) 509-3556
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
- Credentials
- Master of Theology
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27341 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678838400000",
"number": "1366143372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14900 S STEVENS RD",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970458438",
"telephone_number": "301-509-3556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4313 NE TILLAMOOK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131315",
"telephone_number": "971-207-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVALL",
"first_name": "JOSEPH",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "ESQ., LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-15",
"last_updated": "2023-03-15",
"certification_date": "2023-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "27341",
"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 Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.