Individual provider Active NPI

Patrick Davis, LMT

  • Massage Therapist
  • McMinnville, OR
National Provider Identifier
1477284719
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
20557 Issued in OR
Practice address
850 SW Booth Bend Rd
McMinnville, OR 97128-9320
Phone
(503) 472-2111
NPI assigned
Jun 17, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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 20557 OR Primary

Addresses

Primary practice location

850 SW Booth Bend Rd
McMinnville, OR 97128-9320

Mailing address

850 SW Booth Bend Rd
McMinnville, OR 97128-9320
Phone (503) 472-2111

Other identifiers 1

IdentifierTypeStateIssuer
20557OtherORMASSAGE LICENS

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
20557ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Spine and Sport LLC PastSince Jan 2, 2014 Accepting new patients
Bam Beauty and Massage LLC Massage Therapist PastSince Jun 21, 2022 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": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1477284719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SW BOOTH BEND RD",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971289320",
            "telephone_number": "503-472-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SW BOOTH BEND RD",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971289320",
            "telephone_number": "503-472-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PATRICK",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-17",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "20557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENS",
            "identifier": "20557",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.