Active NPI
Lisa MK Sorensen, LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1699039115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 10005
- Practice address
- 16742 SE Division St
Portland, OR 97236-1414 - Phone
- (503) 761-0252
- NPI assigned
- Jun 28, 2012
- 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 | 10005 | OR | Primary |
Addresses
Primary practice location
16742 SE Division St
Portland, OR 97236-1414
Mailing address
17010 SE Stark St
Apt. D311
Portland, OR 97233-6205
Phone (503) 262-0907
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 |
|---|---|---|---|
| 10005 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1699039115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17010 SE STARK ST",
"address_2": "APT. D311",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972336205",
"telephone_number": "503-262-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16742 SE DIVISION ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972361414",
"telephone_number": "503-761-0252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORENSEN",
"first_name": "LISA",
"middle_name": "MK",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-28",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "10005",
"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 Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.