Active NPI
Yarrow Ann Park, LMT, CA
- Massage Therapist
- Gearhart, OR
National Provider Identifier
1639455801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 17586
- Practice address
- 1289 Pacific Way
Gearhart, OR 97138-4360 - Phone
- (503) 738-9796
- Fax
- (503) 717-1378
- NPI assigned
- Nov 1, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 17586 | OR | Primary |
Addresses
Primary practice location
1289 Pacific Way
Gearhart, OR 97138-4360
Mailing address
1289 Pacific Way
Gearhart, OR 97138-4360
Phone (503) 738-9796
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 |
|---|---|---|---|
| 17586 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Way Wellness Center, 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.
-
- Chiropractor
- Gearhart, OR
- NPI 1215218706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320105600000",
"number": "1639455801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1289 PACIFIC WAY",
"city": "GEARHART",
"state": "OR",
"postal_code": "971384360",
"telephone_number": "503-738-9796",
"fax_number": "503-717-1378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1289 PACIFIC WAY",
"city": "GEARHART",
"state": "OR",
"postal_code": "971384360",
"telephone_number": "503-738-9796",
"fax_number": "503-717-1378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "YARROW",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LMT, CA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-01",
"last_updated": "2011-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "17586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gearhart, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.