Individual provider Active NPI

H Eugene Berry Jr., LMP

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1407032881
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00022620 Issued in WA
Practice address
5305 E 18TH St
Suite 151
Vancouver, WA 98661-6583
Phone
(360) 448-0787
NPI assigned
Jan 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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 MA00022620 WA Primary

Addresses

Primary practice location

5305 E 18TH St
Suite 151
Vancouver, WA 98661-6583

Mailing address

58871 Parkwood Dr
Saint Helens, OR 97051-3628
Phone (360) 448-0787

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
MA00022620WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1407032881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58871 PARKWOOD DR",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970513628",
            "telephone_number": "360-448-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 E 18TH ST",
            "address_2": "SUITE 151",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986616583",
            "telephone_number": "360-448-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "H",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00022620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.

Verify at the official NPI Registry.