NPIMap

Organization Active NPI

Lifestyle Nutrition and Massage

  • Health Maintenance Organization
  • Oregon City, OR
National Provider Identifier
1720424062
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
13402 Issued in OR
Legal business name
LIFESTYLE NUTRITION AND MASSAGE
Practice address
418 Beavercreek Rd
Suite #102
Oregon City, OR 97045
Phone
(503) 723-4462
NPI assigned
May 14, 2013
Last updated
May 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Authorized official

Name
Jessie Elise Dolan, LMTNPI 1699978270
Title
Owner, Massage Therapist
Phone
(971) 221-5685

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 13402 OR Primary
Health Maintenance Organization 302R00000X 13385 OR
Health Maintenance Organization 302R00000X 13848 OR

Addresses

Primary practice location

418 Beavercreek Rd
Suite #102
Oregon City, OR 97045

Mailing address

418 Beavercreek Rd
Suite #102
Oregon City, OR 97045-4287
Phone (503) 723-4462

National Provider Directory

National Provider Directory

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": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1720424062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 BEAVERCREEK RD",
            "address_2": "SUITE #102",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454287",
            "telephone_number": "503-723-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 BEAVERCREEK RD",
            "address_2": "SUITE #102",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "97045",
            "telephone_number": "503-723-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE NUTRITION AND MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "DOLAN",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "OWNER, MASSAGE THERAPIST",
        "authorized_official_telephone_number": "971-221-5685",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OR",
            "license": "13402",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OR",
            "license": "13385",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OR",
            "license": "13848",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.