Active NPI
Amanda Marie Drakulich, LMT
- Massage Therapist
- Clackamas, OR
National Provider Identifier
1447812706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 20074
- Practice address
- 9126 SE Saint Helens St # 100a
Clackamas, OR 97015-9780 - Phone
- (503) 482-2122
- NPI assigned
- Jul 7, 2019
- Last updated
- Jul 7, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 20074 | OR | Primary |
Addresses
Primary practice location
9126 SE Saint Helens St # 100a
Clackamas, OR 97015-9780
Mailing address
9126 SE Saint Helens St # 100a
Clackamas, OR 97015-9780
Phone (503) 482-2122
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | dorizatamassage@gmail.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20074 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evexia, LLC | Massage Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562457600000",
"number": "1447812706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9126 SE SAINT HELENS ST # 100A",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159780",
"telephone_number": "503-482-2122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9126 SE SAINT HELENS ST # 100A",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159780",
"telephone_number": "503-482-2122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKULICH",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-07",
"last_updated": "2019-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "20074",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "dorizatamassage@gmail.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "9126 SE Saint Helens St # 100A",
"city": "Clackamas",
"state": "OR",
"country_code": "US",
"postal_code": "970159780",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.