Active NPI
Hannah Heacock, LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1588066039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 19485
- Practice address
- 10151 SW Barbur Blvd
Suite 200
Portland, OR 97219-5931 - Phone
- (503) 245-0454
- NPI assigned
- Sep 16, 2014
- Last updated
- Sep 16, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 19485 | OR | Primary |
| Mechanotherapist | 172M00000X | 19485 | OR |
Addresses
Primary practice location
10151 SW Barbur Blvd
Suite 200
Portland, OR 97219-5931
Mailing address
10151 SW Barbur Blvd
Suite 200
Portland, OR 97219-5931
Phone (503) 245-0454
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 |
|---|---|---|---|
| 19485 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1588066039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10151 SW BARBUR BLVD",
"address_2": "SUITE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972195931",
"telephone_number": "503-245-0454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10151 SW BARBUR BLVD",
"address_2": "SUITE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972195931",
"telephone_number": "503-245-0454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEACOCK",
"first_name": "HANNAH",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "19485",
"primary": true
},
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "OR",
"license": "19485",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- Hazim Dental Clinic PC
- Ziad Hazim, DDS
- Elizabeth A Hazzard, MACOM
- HCP Esl Portland Or Opco LLC (Elmcroft of Sellwood)
- HD Industries, LLC (Home Instead Senior Care)
- Head & Heart Therapy, LLC
- Head & Neck Surgical Associates, PC
- Head Over Heels Birth Education LLC (Head Over Heels Birth)
- Daniel Head
- Erica Charlette Head
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.