Active NPI
Ernesto Alfonso Lara, L.M.T
- Massage Therapist
- Hillsboro, OR
National Provider Identifier
1699011908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 17920
- Practice address
- 5405 SE Alexander St
Hillsboro, OR 97123-8584 - Phone
- (971) 409-8301
- NPI assigned
- Dec 14, 2012
- Sex
- Male
- 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 | 17920 | OR | Primary |
Addresses
Primary practice location
5405 SE Alexander St
Hillsboro, OR 97123-8584
Mailing address
2520 SW 204TH Ave
Beaverton, OR 97006-1871
Phone (971) 409-8301
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 |
|---|---|---|---|
| 17920 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363219200000",
"number": "1699011908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 SW 204TH AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970061871",
"telephone_number": "971-409-8301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5405 SE ALEXANDER ST",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971238584",
"telephone_number": "971-409-8301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARA",
"first_name": "ERNESTO",
"middle_name": "ALFONSO",
"name_prefix": "Mr.",
"credential": "L.M.T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-14",
"last_updated": "2013-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "17920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.