Justin Wycoff, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

22208 Issued in OR

Practice address

6030 SE Division St
Portland, OR 97206-1346

Phone

(503) 772-1215

NPI assigned

Jun 14, 2016

Last updated

Jun 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aaron Armbruster DC LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1962661017
  NPD (past)

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1376993907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SE 11TH AVE",
            "address_2": "APT 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142451",
            "telephone_number": "707-321-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061346",
            "telephone_number": "503-772-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCOFF",
        "first_name": "JUSTIN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "22208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ardyn R Wyatt, LCSW
• Ashley Marie Wyatt
• Ben Wyatt
• Madison Taylor Wyatt
• Solange Marie Wyatt, MD
• Olivia Wycoff
• Mary Jayne Wykowski, LCSW
• Christie Wylde, ND
• Dawn L Wylde, RN/QMHP-C
• Cynthia J Wyler, LMT

• 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 Jun 14, 2016; 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.