Tristan Joseph Soderberg, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

1200 Executive Pkwy Ste 230
Eugene, OR 97401-2365

Phone

(541) 636-3278

NPI assigned

Jun 25, 2020

Last updated

Jun 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Leaf Hyperbarics Eugnene

  • Clinic/Center
  • Eugene, OR
  • NPI 1982060620
  NPD (past)
• NLM Eugene LLC

  dba New Leaf Massage Eugene

  • Clinic/Center
  • Eugene, OR
  • NPI 1710540596
  NPD (past)

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1508483538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 W 17TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023605",
            "telephone_number": "541-844-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EXECUTIVE PKWY STE 230",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012365",
            "telephone_number": "541-636-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERBERG",
        "first_name": "TRISTAN",
        "middle_name": "JOSEPH",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Snyder, DPT
• Peter Charles Snyder, D.D.S.
• Sarah Elizabeth Snyder, M.S.W.
• Susanne A. Snyder
• Vivian Sobol
• Ryan William Solberg, B.A.
• Eleanor Flora Soleil
• Andrew George Solomon
• Ariel Solomon, L.AC.
• Sandra Solomon, MSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.