Individual provider Active NPI

Gabrielle Noel Brown-Wing, LMT

  • Massage Therapist
  • Gresham, OR
National Provider Identifier
1437633112
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
23896 Issued in OR
Practice address
405 NE Division St
Gresham, OR 97030-3947
Phone
(503) 661-0791
NPI assigned
Sep 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 43966 CA
Massage Therapist 225700000X 23896 OR Primary

Addresses

Primary practice location

405 NE Division St
Gresham, OR 97030-3947

Mailing address

110 SE Vista Ave Apt 1
Gresham, OR 97080-8051
Phone (925) 864-9834

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
43966CAMDMassage Therapist
23896ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kuns Chiropractic Clinic Past Accepting new patients
Kuns Chiropractic Clinic Inc Past Accepting new patients

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": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1437633112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SE VISTA AVE APT 1",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970808051",
            "telephone_number": "925-864-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 NE DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303947",
            "telephone_number": "503-661-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN-WING",
        "first_name": "GABRIELLE",
        "middle_name": "NOEL",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "43966",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "23896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.