Mohammad-Amin Safar-Ali Bonakdar, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

26905 Issued in OR

Practice address

21400 Salamo Rd
West Linn, OR 97068-7201

Phone

(503) 650-2487

NPI assigned

Mar 30, 2022

Last updated

Mar 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Ameen Safar-Ali Bonakdar Other name

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": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1588304406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 SW PELICAN WAY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970078944",
            "telephone_number": "971-344-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21400 SALAMO RD",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970687201",
            "telephone_number": "503-650-2487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11900 SW Pelican Way",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970078944",
            "country_code": "US",
            "telephone_number": "971-344-0009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONAKDAR",
        "first_name": "MOHAMMAD-AMIN",
        "middle_name": "SAFAR-ALI",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "26905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMEEN",
            "last_name": "BONAKDAR",
            "middle_name": "SAFAR-ALI",
            "prefix": "MR.",
            "credential": "LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Massage Therapist in West Linn, OR
• Providers in West Linn, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.