Individual provider Active NPI

Tammy Holder, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1508016668
Registry record updated Sep 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
10548 Issued in OR
Practice address
8113 SE 13TH Ave
Portland, OR 97202-6607
Phone
(503) 984-6133
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10548 OR
Massage Therapist 225700000X 10548 OR Primary

Addresses

Primary practice location

8113 SE 13TH Ave
Portland, OR 97202-6607

Mailing address

2011 SE Sparrow St
Milwaukie, OR 97222-7860
Phone (503) 984-6133

Other practice location 1

1540 SE Clinton St
Portland, OR 97202-1130
Phone (503) 984-6133

Other identifiers 1

IdentifierTypeStateIssuer
10548OtherORLMT

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
10548ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1508016668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 SE SPARROW ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227860",
            "telephone_number": "503-984-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8113 SE 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026607",
            "telephone_number": "503-984-6133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 SE Clinton St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972021130",
            "country_code": "US",
            "telephone_number": "503-984-6133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "TAMMY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "10548",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "10548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT",
            "identifier": "10548",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 17, 2018; 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.