NPIMap

Organization Active NPI

Active Life Therapeutic Massage

  • Massage Therapist
  • Bend, OR
National Provider Identifier
1699208629
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
ACTIVE LIFE THERAPEUTIC MASSAGE
Practice address
325 NW Vermont St
Suite 101
Bend, OR 97703-1916
Phone
(541) 480-1427
Fax
(541) 833-0763
NPI assigned
Apr 6, 2017
Last updated
Apr 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Stephanie Wehrhan, LMTNPI 1821466418
Title
Owner
Phone
(541) 480-1427

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Primary

Addresses

Primary practice location

325 NW Vermont St
Suite 101
Bend, OR 97703-1916

Mailing address

325 NW Vermont St
Suite 101
Bend, OR 97703-1916
Phone (541) 480-1427

National Provider Directory

National Provider Directory

Locations

325 NW Vermont St
Ste 101
Bend, OR 97703
Phone (541) 480-1427

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1699208629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 NW VERMONT ST",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031916",
            "telephone_number": "541-480-1427",
            "fax_number": "541-833-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 NW VERMONT ST",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031916",
            "telephone_number": "541-480-1427",
            "fax_number": "541-833-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE THERAPEUTIC MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "WEHRHAN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-480-1427",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.