Individual provider Active NPI

Jamie Tinsley-Shannon Rolan, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1437979176
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
28486 Issued in OR
Practice address
1517 NE Broadway St
Portland, OR 97232-1406
Phone
(503) 946-8450
NPI assigned
Oct 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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 28486 OR Primary

Addresses

Primary practice location

1517 NE Broadway St
Portland, OR 97232-1406

Mailing address

1517 NE Broadway St
Portland, OR 97232-1406
Phone (503) 946-8450

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
28486ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Wine Spa LLC Massage Therapist CurrentSince Nov 8, 2025 Accepting new patients
Wellness on Wheels LLC Massage Therapist CurrentSince Oct 20, 2024 Accepting new patients

Locations

1517 NE Broadway St
Portland, OR 97232
Phone (503) 946-8450

3530 SW Multnomah Blvd
Portland, OR 97219
Phone (503) 752-0917

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": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1437979176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321406",
            "telephone_number": "503-946-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321406",
            "telephone_number": "503-946-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAN",
        "first_name": "JAMIE",
        "middle_name": "TINSLEY-SHANNON",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "28486",
            "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 Oct 23, 2025; 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.