Lois Elizabeth Yevdalcia Dimick, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

11715 Issued in OR

Practice address

2004 Main St
Suite 204
Forest Grove, OR 97116

Phone

(503) 380-7753

Fax

(503) 359-4760

NPI assigned

Mar 15, 2007

Sex

Female

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

• Miss Lois Elizabeth Yevdalcia Camarillo Former 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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629102454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 28TH AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "97116",
            "telephone_number": "503-380-7753",
            "fax_number": "503-359-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 MAIN ST",
            "address_2": "SUITE 204",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "97116",
            "telephone_number": "503-380-7753",
            "fax_number": "503-359-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMICK",
        "first_name": "LOIS ELIZABETH",
        "middle_name": "YEVDALCIA",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "11715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOIS ELIZABETH",
            "last_name": "CAMARILLO",
            "middle_name": "YEVDALCIA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rosaisela Delgado Ferreyra
• Erin Michelle Derosia, P.T.
• Steven Raymond Dierickx, DMD
• Margaret Digiulian
• Rachel Lucinda Erin Dilly, SLP
• Jobe Hoang Dinh
• Leonardo Daniel Dominguez
• Donald a. Compton DMD, P.C.
• Gage Matthew Draper, OD
• Sydney Rose Dreyer

• Massage Therapist in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.