Active NPI
Emilio Shivers, LMT
- Massage Therapist
- Wilsonville, OR
National Provider Identifier
1669877403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21002
- Practice address
- 25700 SW Argyle Ave
Wilsonville, OR 97070-5799 - Phone
- (503) 582-9805
- Fax
- (503) 582-9795
- NPI assigned
- Oct 22, 2014
- Sex
- Male
- Sole proprietor
- No
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 | 21002 | OR | Primary |
Addresses
Primary practice location
25700 SW Argyle Ave
Wilsonville, OR 97070-5799
Mailing address
25700 SW Argyle Ave
Wilsonville, OR 97070-5799
Phone (503) 582-9805
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 |
|---|---|---|---|
| 21002 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413936000000",
"number": "1669877403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25700 SW ARGYLE AVE",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970705799",
"telephone_number": "503-582-9805",
"fax_number": "503-582-9795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25700 SW ARGYLE AVE",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970705799",
"telephone_number": "503-582-9805",
"fax_number": "503-582-9795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVERS",
"first_name": "EMILIO",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-22",
"last_updated": "2014-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "21002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilsonville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.