Massotherapy Clinic, PC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

1068 Issued in OR

Legal business name

MASSOTHERAPY CLINIC, PC

Practice address

1220 SW Morrison Suite 410
Portland, OR 97205

Phone

(503) 226-1948

Fax

(503) 226-1598

NPI assigned

Apr 30, 2012

Organization subpart

No

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

Authorized official

Name

Susanne Carlson, MS, LMT

Title

President

Phone

(503) 226-1948

Specialties & licenses 2

Addresses

Other names 1

• Susanne Carlson, president, provider, Anne Dryad, provider Other name

Locations

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1497013296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SW MORRISON SUITE 410",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-226-1948",
            "fax_number": "503-226-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SW MORRISON SUITE 410",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-226-1948",
            "fax_number": "503-226-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSOTHERAPY CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-226-1948",
        "authorized_official_credential": "MS, LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "1068",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "1151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susanne Carlson, president, provider, Anne Dryad, provider",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maraya Karena Massin-Levey
• Summer Morgan Massina, ARNP
• Steven Massingale, PTA
• Heather Masson-Spicer, LCSW
• Angela Massoni-Blaine
• John George Grace Massoud, MD
• Master Dental Smiles Inc
• Mitesh Master, L.AC.
• Abigail Phyllis Masters
• Andrea Lane Masters

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.