Individual provider Active NPI

Kiya Tenney, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1407332745
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
529 SE Grand Ave Ste 300D
Portland, OR 97214-2232
Phone
(503) 410-3013
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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 WA Primary

Addresses

Primary practice location

529 SE Grand Ave Ste 300D
Portland, OR 97214-2232

Mailing address

5630 NE Couch St
Portland, OR 97213-3728

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Moss Wellness LLC Massage Therapist CurrentSince Mar 31, 2024 Accepting new patients
Smart Therapy, LLC PastSince May 15, 2016 Accepting new patients

Locations

529 SE Grand Ave
Ste 300D
Portland, OR 97214
Phone (503) 410-3013

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1407332745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 NE COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 SE GRAND AVE STE 300D",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142232",
            "telephone_number": "503-410-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNEY",
        "first_name": "KIYA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": null,
            "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 Mar 27, 2024; 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.