Active NPI
Adela Theodora Basayne, M.A., L.M.T.
- Massage Therapist
- Portland, OR
National Provider Identifier
1386891752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2556
- Practice address
- 116 N Page St
Portland, OR 97227-1909 - Phone
- (503) 975-8713
- NPI assigned
- Aug 27, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 2556 | OR | Primary |
Addresses
Primary practice location
116 N Page St
Portland, OR 97227-1909
Mailing address
4940 SW Hewett Blvd
Portland, OR 97221-2205
Phone (503) 975-8713
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2556 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1386891752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4940 SW HEWETT BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972212205",
"telephone_number": "503-975-8713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 N PAGE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271909",
"telephone_number": "503-975-8713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASAYNE",
"first_name": "ADELA",
"middle_name": "THEODORA",
"credential": "M.A., L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-27",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "2556",
"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 Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.