Elizabeth Jane Cannon, LMBT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

11670 Issued in NC

Practice address

2303 E Burnside St
Portland, OR 97214-1655

Phone

(503) 213-6907

NPI assigned

Oct 15, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1508118563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 NW SAVIER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102415",
            "telephone_number": "706-410-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141655",
            "telephone_number": "503-213-6907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2715 NW Savier St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972102415",
            "country_code": "US",
            "telephone_number": "706-410-0982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "credential": "LMBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "11670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Kimberly Canizales
• Erik Neil Cannard, LMT
• Andree Louise Cannon-Fleming, LPC
• Carolyn Cannon, OT/L
• Elinor Cannon
• Erin Cannon, LPC
• Evelyn Cannon
• Keli Mikal Cannon
• Jackie Elise Cano, MA
• Marissa Cano

• 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 Dec 21, 2022; 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.