Ricardo M Deaustria Jr., LMT

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

15490 Issued in OR

Practice address

2701 NW Vaughn St Ste 154
Portland, OR 97210-5349

Phone

(503) 719-4326

NPI assigned

Dec 2, 2008

Last updated

Sep 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Bodywork for the Active

  • Mechanotherapist
  • Portland, OR
  • NPI 1528486982
  NPD (past)
• Sulis Chiropractic LLC

  • Chiropractor
  • Portland, OR
  • NPI 1770732265
  NPD (past)

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1447495601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 NW VAUGHN ST STE 154",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105349",
            "telephone_number": "503-719-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NW VAUGHN ST STE 154",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105349",
            "telephone_number": "503-719-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAUSTRIA",
        "first_name": "RICARDO",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-02",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "15490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David A Deardorff, MD
• Brooke Alexis Dearman
• Julia Dearmond, PMHNP, APRN, BC
• Sarah Beth Deason
• Scott Phillip Deaton, P.A.
• Luanne Marie Deautremont
• Joanne K Deazley, PT
• Deb Kiehlmeier DO LLC
• Lynn Larson Debar, PH.D.
• Rachael Debarmore, RPH

• Mechanotherapist in Portland, OR
• Providers in Portland, OR by specialty
• Mechanotherapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.