Individual provider Active NPI

Emily Dawn Duforest, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1427735877
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27764 Issued in OR
Practice address
13152 SE Rusk Rd
Portland, OR 97222-2171
Phone
(503) 919-7001
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 27764 OR Primary

Addresses

Primary practice location

13152 SE Rusk Rd
Portland, OR 97222-2171

Mailing address

9864 SE 38TH Ave
Portland, OR 97222-5778
Phone (530) 264-6738

Other names 1

  • Emily Carter Former name

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
27764ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Health Inc Single Specialty CurrentSince Jul 2, 2023 Accepting new patients
Pivot Health Inc PastSince Jul 2, 2023 Accepting new patients

Locations

13152 SE Rusk Rd
Portland, OR 97222
Phone (503) 919-7001

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": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1427735877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9864 SE 38TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972225778",
            "telephone_number": "530-264-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13152 SE RUSK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972222171",
            "telephone_number": "503-919-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFOREST",
        "first_name": "EMILY",
        "middle_name": "DAWN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "27764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "CARTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jun 28, 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.