Individual provider Active NPI

Madelyn Ac Burnham, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1396438354
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27688 Issued in OR
Practice address
8288 SE 13TH Ave
Portland, OR 97202-6610
Phone
(503) 477-9037
NPI assigned
May 26, 2023
Last updated
May 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
27688ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yomassage Company Massage Therapist CurrentSince May 28, 2023 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.

Verify at the official NPI Registry.