NPIMap

Organization Active NPI

Massage and Spa at Bethany

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1649717141
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
20527 Issued in OR
Legal business name
MASSAGE AND SPA AT BETHANY
Practice address
15280 NW Central Dr
102
Portland, OR 97229-7805
Phone
(503) 533-5614
NPI assigned
Jan 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer L Oulds, LMT
Title
Owner/Therapist
Phone
(503) 533-5614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 20527 OR Primary

Addresses

Primary practice location

15280 NW Central Dr
102
Portland, OR 97229-7805

Mailing address

15280 NW Central Dr
102
Portland, OR 97229-7805
Phone (503) 533-5614

National Provider Directory

National Provider Directory

Locations

15280 NW Central Dr
Ste 102
Portland, OR 97229
Phone (503) 533-5614

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1649717141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW CENTRAL DR",
            "address_2": "102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297805",
            "telephone_number": "503-533-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15280 NW CENTRAL DR",
            "address_2": "102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297805",
            "telephone_number": "503-533-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSAGE AND SPA AT BETHANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "OULDS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "503-533-5614",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "20527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.