Individual provider Active NPI

David Alexander Gasporra, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1609108992
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
6498 Issued in OR
Practice address
1104 SW Columbia St Ste 2
Portland, OR 97201-3498
Phone
(503) 224-8623
NPI assigned
Feb 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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 6498 OR Primary

Addresses

Primary practice location

1104 SW Columbia St Ste 2
Portland, OR 97201-3498

Mailing address

1104 SW Columbia St Ste 2
Portland, OR 97201-3498
Phone (503) 224-8623

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
6498ORMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1609108992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 SW COLUMBIA ST STE 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972013498",
            "telephone_number": "503-224-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 SW COLUMBIA ST STE 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972013498",
            "telephone_number": "503-224-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASPORRA",
        "first_name": "DAVID",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "6498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.