NPIMap

Organization Active NPI

Spa Willamina

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1619278512
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
SPA WILLAMINA
Practice address
1928 NE 40TH Ave.
Portland, OR 97212
Phone
(503) 287-2787
NPI assigned
Nov 9, 2010
Last updated
Nov 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Authorized official

Name
Willow Light
Title
Owner
Phone
(503) 287-2787

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X NU Primary

Addresses

Primary practice location

1928 NE 40TH Ave.
Portland, OR 97212

Mailing address

1928 NE 40TH Ave.
Portland, OR 97212
Phone (503) 287-2787

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1619278512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 NE 40TH AVE.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97212",
            "telephone_number": "503-287-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 NE 40TH AVE.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97212",
            "telephone_number": "503-287-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA WILLAMINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "WILLOW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-287-2787"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "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 Nov 9, 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.