Lisa D Blake, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

18230 Issued in OR

Practice address

2705 E Burnside St Ste 213
Portland, OR 97214-1768

Phone

(503) 234-4288

NPI assigned

Oct 2, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wilkes Family Investments LLC

  • Chiropractor
  • Portland, OR
  • NPI 1245433507
  NPD (past)
• Wilkes Family Investments LLC

  • Chiropractor
  • Portland, OR
  • NPI 1447040423
  NPD (past)

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1730699976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5319 SE 69TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972065343",
            "telephone_number": "603-219-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 E BURNSIDE ST STE 213",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141768",
            "telephone_number": "503-234-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "LISA",
        "middle_name": "D",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "18230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Dejen Blake, LMT
• Eric Michael Blake, N.D.
• Janelle L Blake, RN
• Linda Cherise Blake, PHARMD, PHD
• Lindsey Blake
• Tyschal Lumbrea Blake
• Kerra E Blakely, CADC, LCSW
• Thomas Lawrence Blakely, CCC-SLP
• Cortney C Blakemore, CRNA
• Rachel Hope Blakemore, OD

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.