Active NPI
Samantha Bangone Lewis, L.M.T.
- Massage Therapist
- Beaverton, OR
National Provider Identifier
1376683045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12490
- Practice address
- 13185 SW Butner CT
Beaverton, OR 97005-0833 - Phone
- (503) 806-4652
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 12490 | OR | Primary |
| Massage Therapist | 225700000X | MA00021799 | WA |
Addresses
Primary practice location
13185 SW Butner CT
Beaverton, OR 97005-0833
Mailing address
13185 SW Butner CT
Beaverton, OR 97005-0833
Phone (503) 806-4652
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12490 | OR | MD | Massage Therapist |
| MA00021799 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492041600000",
"number": "1376683045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13185 SW BUTNER CT",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970050833",
"telephone_number": "503-806-4652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13185 SW BUTNER CT",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970050833",
"telephone_number": "503-806-4652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "SAMANTHA",
"middle_name": "BANGONE",
"name_prefix": "Mrs.",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2017-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "12490",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00021799",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.