Individual provider Active NPI

Anna Belle Vacheresse

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1548854516
Registry record updated Feb 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
26202 Issued in OR
Practice address
913 SW 16TH Ave
Portland, OR 97205-1730
Phone
(503) 228-5000
NPI assigned
Feb 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 26202 OR Primary

Addresses

Primary practice location

913 SW 16TH Ave
Portland, OR 97205-1730

Mailing address

1450 SW Jefferson St Apt 511
Portland, OR 97201-2637
Phone (503) 462-2827

Other names 1

  • Anna Drahos-Vacheresse Former name

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

LicenseStateTypeSpecialty
26202ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Equilibrium LLC CurrentSince Mar 4, 2021 Accepting new patients
Melissa Miesen, PC Massage Therapist PastSince Mar 4, 2021 Accepting new patients

Locations

913 SW 16th Ave
Portland, OR 97205
Phone (503) 228-5000

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613865600000",
    "number": "1548854516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 SW JEFFERSON ST APT 511",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972012637",
            "telephone_number": "503-462-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 SW 16TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051730",
            "telephone_number": "503-228-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHERESSE",
        "first_name": "ANNA BELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2021-02-21",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "26202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "DRAHOS-VACHERESSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2021; 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.