Active NPI
Susan Clarke, LMT
- Massage Therapist
- Tigard, OR
National Provider Identifier
1528778057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 14419
- Practice address
- 7340 SW Hunziker Rd Ste 101
Tigard, OR 97223-2303 - Phone
- (503) 624-7249
- NPI assigned
- Nov 23, 2022
- Last updated
- Nov 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 14419 | OR | Primary |
Addresses
Primary practice location
7340 SW Hunziker Rd Ste 101
Tigard, OR 97223-2303
Mailing address
7507 SW 25TH Ave
Portland, OR 97219-2529
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 |
|---|---|---|---|
| 14419 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pioneer Chiropractic & Wellness | Current | Accepting new patients |
Locations
7340 SW Hunziker Rd
Ste 101
Tigard, OR 97223
Phone (503) 488-5485
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669161600000",
"number": "1528778057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7507 SW 25TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972192529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7340 SW HUNZIKER RD STE 101",
"city": "TIGARD",
"state": "OR",
"postal_code": "972232303",
"telephone_number": "503-624-7249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "SUSAN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-23",
"last_updated": "2022-11-23",
"certification_date": "2022-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "14419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.