Individual provider Active NPI

W. Michael Wolf, L.M.T.

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1700071735
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
3185 Issued in OR
Practice address
325 NW 21St Ave
Portland, OR 97209-1174
Phone
(503) 288-9107
NPI assigned
Sep 12, 2007
Last updated
Sep 12, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 3185 OR Primary

Addresses

Primary practice location

325 NW 21St Ave
Portland, OR 97209-1174

Mailing address

3126 NE 7TH Ave
Portland, OR 97212-3141
Phone (503) 288-9107

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

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1700071735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 NE 7TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123141",
            "telephone_number": "503-288-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 NW 21ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091174",
            "telephone_number": "503-288-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "W.",
        "middle_name": "MICHAEL",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "3185",
            "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 Sep 12, 2007; 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.