Individual provider Active NPI

Lisa Perry

  • Massage Therapist
  • Beaverton, OR
National Provider Identifier
1558819268
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
19566 Issued in OR
Practice address
12750 SW 2ND St Ste 203
Beaverton, OR 97005-2779
Phone
(971) 409-1979
NPI assigned
Sep 12, 2016
Last updated
May 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 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 19566 OR Primary

Addresses

Primary practice location

12750 SW 2ND St Ste 203
Beaverton, OR 97005-2779

Mailing address

5329 SE Pueblo St
Hillsboro, OR 97123-8131

Other practice location 1

5329 SE Pueblo St
Hillsboro, OR 97123-8131
Phone (971) 337-4593

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
19566ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Care LLC Massage Therapist Current Accepting new patients
Vital Billing LLC Massage Therapist Current Accepting new patients
Vital Massage LLC Massage Therapist Current Accepting new patients

Locations

12750 SW 2nd St
Ste 203
Beaverton, OR 97005
Phone (503) 915-9618

Organizations & group practices 3

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1558819268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5329 SE PUEBLO ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971238131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 SW 2ND ST STE 203",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052779",
            "telephone_number": "971-409-1979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5329 SE Pueblo St",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971238131",
            "country_code": "US",
            "telephone_number": "971-337-4593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.