Jennifer Norita Wiesert, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

26213 Issued in OR

Practice address

4239 NE 79TH Ave
Portland, OR 97218-4203

Phone

(458) 205-4126

NPI assigned

Feb 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1548914468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4239 NE 79TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972184203",
            "telephone_number": "458-205-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4239 NE 79TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972184203",
            "telephone_number": "458-205-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESERT",
        "first_name": "JENNIFER",
        "middle_name": "NORITA",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "26213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "454500222",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Massagebook",
            "affiliation": "N",
            "endpointDescription": "Massagebook",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4239 NE 79th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972184203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Dianne Wiens, PSY.D
• Taiya Wiers
• Brenda Imogen Wierschin, LCSW
• Maureen L Wiese, C.PED
• Maureen Wieser
• Allana Wiesinger
• Kevin M Wiesmann, M.D.
• Julie Hassen Wiesner, LCSW
• Hazel Carlos Wiesse-Perez, MSW
• Christy Ann Wiessner, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.

Verify at the official NPI Registry.