Active NPI
Tanya Eileen Larson, L.M.T., NCTMB
- Massage Therapist
- Medford, OR
National Provider Identifier
1649474016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 13245
- Practice address
- 2951 Doctors Park Dr
Medford, OR 97504-8127 - Phone
- (541) 776-9813
- NPI assigned
- Jun 12, 2007
- 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 | 13245 | OR | Primary |
Addresses
Primary practice location
2951 Doctors Park Dr
Medford, OR 97504-8127
Mailing address
2019 Aero Way
Suite 103, PMB 194
Medford, OR 97504-9789
Phone (541) 941-9657
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 |
|---|---|---|---|
| 13245 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649474016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2019 AERO WAY",
"address_2": "SUITE 103, PMB 194",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975049789",
"telephone_number": "541-941-9657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2951 DOCTORS PARK DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048127",
"telephone_number": "541-776-9813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "TANYA",
"middle_name": "EILEEN",
"credential": "L.M.T., NCTMB",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "13245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- 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.