NPIMap

Organization Active NPI

Spa Sasse LLC

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1710468780
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SPA SASSE LLC
Practice address
630 SW Alder St
Portland, OR 97205-3616
Phone
(503) 228-8266
NPI assigned
Aug 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Authorized official

Name
Sara Sasse, LMTNPI 1932680907
Title
Managing Member
Phone
(808) 283-6669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

630 SW Alder St
Portland, OR 97205-3616

Mailing address

PO Box 22266
Portland, OR 97269-2266
Phone (503) 228-8266

National Provider Directory

National Provider Directory

Locations

630 SW Alder St
Portland, OR 97205
Phone (503) 228-8266

Practitioners & affiliated clinicians

Practitioners 2

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": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535328000000",
    "number": "1710468780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22266",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972692266",
            "telephone_number": "503-228-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 SW ALDER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053616",
            "telephone_number": "503-228-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA SASSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A",
        "authorized_official_last_name": "SASSE",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "808-283-6669",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "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 Aug 27, 2018; 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.