Penny Harrison, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2983 Issued in OR

Practice address

8550 SW Apple Way
Portland, OR 97225-1772

Phone

(503) 523-7836

Fax

(503) 894-9699

NPI assigned

Aug 25, 2021

Last updated

Aug 25, 2021By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Theology

Practice roles

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.

• Mary Ann Penny Domm

  dba JNA Chiropractic, LLC

  • Health Service Clinic/Center
  • Portland, OR
  • NPI 1396154944
  NPD (past)

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1629745898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 SW APPLE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251772",
            "telephone_number": "503-523-7836",
            "fax_number": "503-894-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 SW APPLE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251772",
            "telephone_number": "503-523-7836",
            "fax_number": "503-894-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "PENNY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "2983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139615944",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelli Kay Harrison, QMHA
• Kelly Harrison
• Marvin William Harrison, MD
• Molly Harrison, LEC, PPD, NCS
• Natasha Lauren Harrison
• Polly Elizabeth Harrison
• Rebecca Ann Harrison, MD
• Ross Harrison, MD
• Tela Renee Harrison, CCMA, CD(DONA)
• Travon Harrison

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.