Active NPI
Kaitlyn R Daily, LMT
- Massage Therapist
- Gresham, OR
National Provider Identifier
1619433968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 24641
- Practice address
- 501 NE Hood Ave
Suite 205
Gresham, OR 97030 - Phone
- (503) 674-7894
- Fax
- (503) 674-7899
- NPI assigned
- Feb 12, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 24641 | OR | Primary |
Addresses
Primary practice location
501 NE Hood Ave
Suite 205
Gresham, OR 97030
Mailing address
21707 SE Stark St
Gresham, OR 97030-2029
Phone (971) 570-5814
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 |
|---|---|---|---|
| 24641 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Family Chiropractic, LLC | 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 and National Provider Directory roles.
-
- Sports Physician Chiropractor
- Gresham, OR
- NPI 1104221530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711411200000",
"number": "1619433968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21707 SE STARK ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970302029",
"telephone_number": "971-570-5814",
"fax_number": "866-454-3512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 NE HOOD AVE",
"address_2": "SUITE 205",
"city": "GRESHAM",
"state": "OR",
"postal_code": "97030",
"telephone_number": "503-674-7894",
"fax_number": "503-674-7899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAILY",
"first_name": "KAITLYN",
"middle_name": "R",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-12",
"last_updated": "2024-03-26",
"certification_date": "2024-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "24641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.