NPIMap

Organization Active NPI

Modagrant

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1497153258
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
MODAGRANT
Practice address
5622 SE Tolman St
Portland, OR 97206-6861
Phone
(503) 307-3461
NPI assigned
Dec 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Mrs. Monika Grant, LMT/ESTHETICIAN
Title
Owner
Phone
(503) 307-3461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

5622 SE Tolman St
Portland, OR 97206-6861

Mailing address

5622 SE Tolman St
Portland, OR 97206-6861
Phone (503) 307-3461

Other names 1

  • Natural Abundance Wellness Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1497153258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5622 SE TOLMAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972066861",
            "telephone_number": "503-307-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5622 SE TOLMAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972066861",
            "telephone_number": "503-307-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODAGRANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-307-3461",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT/ESTHETICIAN"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Natural Abundance Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 10, 2014; 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.