Individual provider Active NPI

Jennifer Thompson

  • Massage Therapist
  • West Linn, OR
National Provider Identifier
1629472394
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
20312 Issued in OR
Practice address
22000 Willamette Dr Ste 107
West Linn, OR 97068-3210
Phone
(503) 722-8888
Fax
(503) 722-0202
NPI assigned
Oct 9, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 20312 OR Primary

Addresses

Primary practice location

22000 Willamette Dr Ste 107
West Linn, OR 97068-3210

Mailing address

22000 Willamette Dr Ste 107
West Linn, OR 97068-3210
Phone (503) 722-8888

Other practice location 1

1750 Blankenship Rd Ste 295
West Linn, OR 97068-5104
Phone (503) 344-4378

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
20312ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elements Therapeutic Massage Massage Therapist PastSince Jul 24, 2022 Accepting new patients
Revive Injury and Wellness, PC PastSince Oct 17, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629472394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22000 WILLAMETTE DR STE 107",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683210",
            "telephone_number": "503-722-8888",
            "fax_number": "503-722-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22000 WILLAMETTE DR STE 107",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683210",
            "telephone_number": "503-722-8888",
            "fax_number": "503-722-0202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 Blankenship Rd Ste 295",
            "address_purpose": "LOCATION",
            "city": "West Linn",
            "state": "OR",
            "postal_code": "970685104",
            "country_code": "US",
            "telephone_number": "503-344-4378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "20312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.