Active NPI
Madelyn Ac Burnham, LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1396438354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 27688
- Practice address
- 8288 SE 13TH Ave
Portland, OR 97202-6610 - Phone
- (503) 477-9037
- NPI assigned
- May 26, 2023
- Last updated
- May 26, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 27688 | OR | Primary |
Addresses
Primary practice location
8288 SE 13TH Ave
Portland, OR 97202-6610
Mailing address
1976 NW Pettygrove St Apt 212
Portland, OR 97209-1694
Phone (503) 722-4021
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 |
|---|---|---|---|
| 27688 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yomassage Company | Massage Therapist | Current | Accepting new patients |
Locations
8288 SE 13th Ave
Portland, OR 97202
Phone (503) 477-9037
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685059200000",
"number": "1396438354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1976 NW PETTYGROVE ST APT 212",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972091694",
"telephone_number": "503-722-4021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8288 SE 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972026610",
"telephone_number": "503-477-9037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNHAM",
"first_name": "MADELYN",
"middle_name": "AC",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-26",
"last_updated": "2023-05-26",
"certification_date": "2023-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "27688",
"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 May 26, 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.