Chrystal Shaw LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

20397 Issued in OR

Legal business name

CHRYSTAL SHAW LMT

Practice address

6200 NE 32ND PL
Portland, OR 97211-6720

Phone

(503) 381-9876

NPI assigned

Sep 11, 2014

Organization subpart

No

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

Authorized official

Name

Chrystal Shaw, LMT

Title

Owner

Phone

(503) 381-9876

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1376944033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 NE 32ND PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 NE 32ND PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116720",
            "telephone_number": "503-381-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSTAL SHAW LMT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "CHRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-381-9876",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "20397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Portland, OR
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.