Active NPI
Daniela M Lostumbo-Frelly, LMT
- Reflexologist
- Beaverton, OR
National Provider Identifier
1710241708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Reflexologist
- License
- 18475
- Practice address
- 2077 NW Town Center Dr
Beaverton, OR 97006-8938 - Phone
- (503) 597-7780
- Fax
- (503) 746-4891
- NPI assigned
- Jun 25, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Reflexologist | 173C00000X | 18475 | OR | Primary |
Addresses
Primary practice location
2077 NW Town Center Dr
Beaverton, OR 97006-8938
Mailing address
10749 SW Canterbury LN Ste 101
Tigard, OR 97224-3874
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 |
|---|---|---|---|
| 18475 | OR | MD | Reflexologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340582400000",
"number": "1710241708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10749 SW CANTERBURY LN STE 101",
"city": "TIGARD",
"state": "OR",
"postal_code": "972243874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2077 NW TOWN CENTER DR",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970068938",
"telephone_number": "503-597-7780",
"fax_number": "503-746-4891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOSTUMBO-FRELLY",
"first_name": "DANIELA",
"middle_name": "M",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-25",
"last_updated": "2012-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "173C00000X",
"taxonomy_group": "",
"desc": "Reflexologist",
"state": "OR",
"license": "18475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.