Active NPI
Jill Courtney Walters, LMT
- Massage Therapist
- Scappoose, OR
National Provider Identifier
1508030966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 11046
- Practice address
- 51669 Columbia River Hwy
Ste. 130
Scappoose, OR 97056-4508 - Phone
- (503) 543-8605
- Fax
- (503) 210-8166
- NPI assigned
- Apr 16, 2008
- Last updated
- Apr 16, 2008
- 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 | 11046 | OR | Primary |
Addresses
Primary practice location
51669 Columbia River Hwy
Ste. 130
Scappoose, OR 97056-4508
Mailing address
51669 Columbia River Hwy
Ste. 130
Scappoose, OR 97056-4508
Phone (503) 543-8605
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 |
|---|---|---|---|
| 11046 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1508030966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51669 COLUMBIA RIVER HWY",
"address_2": "STE. 130",
"city": "SCAPPOOSE",
"state": "OR",
"postal_code": "970564508",
"telephone_number": "503-543-8605",
"fax_number": "503-210-8166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51669 COLUMBIA RIVER HWY",
"address_2": "STE. 130",
"city": "SCAPPOOSE",
"state": "OR",
"postal_code": "970564508",
"telephone_number": "503-543-8605",
"fax_number": "503-210-8166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "JILL",
"middle_name": "COURTNEY",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-16",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "11046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scappoose, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.