NPIMap

Organization Active NPI

At Ease Massage Therapy, LLC

  • Mechanotherapist
  • Tigard, OR
National Provider Identifier
1538445135
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
10755 Issued in OR
Legal business name
AT EASE MASSAGE THERAPY, LLC
Practice address
15495 SW Sequoia Pkwy
Suite 150
Tigard, OR 97224-6100
Phone
(503) 957-0338
NPI assigned
Oct 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Authorized official

Name
Mr. Brian Daryl Buckner, L.M.T.
Title
Ceo
Phone
(503) 957-0338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MechanotherapistGroup: 193400000X SINGLE SPECIALTY GROUP 172M00000X 10755 OR Primary

Addresses

Primary practice location

15495 SW Sequoia Pkwy
Suite 150
Tigard, OR 97224-6100

Mailing address

15495 SW Sequoia Pkwy.
Suite 150
Tigard, OR 97224-6117
Phone (503) 957-0338

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1538445135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15495 SW SEQUOIA PKWY.",
            "address_2": "SUITE 150",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972246117",
            "telephone_number": "503-957-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15495 SW SEQUOIA PKWY",
            "address_2": "SUITE 150",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972246100",
            "telephone_number": "503-957-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT EASE MASSAGE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DARYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-957-0338",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.M.T."
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "10755",
            "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 Oct 26, 2011; 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.