Active NPI
Sophia Baca
- Massage Therapist
- Hillsboro, OR
National Provider Identifier
1558937813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21887
- Practice address
- 2167 NW 185TH Ave
Hillsboro, OR 97124-7074 - Phone
- (503) 828-1311
- NPI assigned
- May 27, 2021
- Last updated
- May 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 21887 | OR | Primary |
Addresses
Primary practice location
2167 NW 185TH Ave
Hillsboro, OR 97124-7074
Mailing address
6086 SW 161St Ave
Beaverton, OR 97007-4012
Phone (505) 946-8327
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21887 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marcotte Studio One | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1558937813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6086 SW 161ST AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970074012",
"telephone_number": "505-946-8327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2167 NW 185TH AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971247074",
"telephone_number": "503-828-1311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACA",
"first_name": "SOPHIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-27",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "21887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, 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.