Tina Russell, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT4120 Issued in ME

Practice address

1023 Washington Ave
Portland, ME 04103-2793

Phone

(207) 773-5778

Fax

(207) 773-5773

NPI assigned

Apr 3, 2026

Last updated

Apr 3, 2026By the provider in NPPES

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

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.

• Jade Trade Inc.

  • Physical Therapist
  • Portland, ME
  • NPI 1578753836

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1775174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1548101470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 WASHINGTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032793",
            "fax_number": "207-773-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 WASHINGTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032793",
            "telephone_number": "207-773-5778",
            "fax_number": "207-773-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "TINA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-03",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "ME",
            "license": "MT4120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George H Russell, MD
• J. Maxwell Russell IV, DO
• Keith Edmund Russell, DMD
• Marlena Russell
• Rachel Russell, FNP-C
• Susan J Russett-Collett, DDS
• Brett Russman, LCSW
• Donovan Russo-Mingle, DO
• Julia Russo
• Michael Anthony Russo, N.D.

• Massage Therapist in Portland, ME
• Providers in Portland, ME by specialty
• Massage Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.