Peter D Black, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

24898 Issued in OR

Practice address

2610 SE Clinton St Ste E
Portland, OR 97202-1273

Phone

(808) 280-6470

NPI assigned

Aug 26, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Black Enterprises, Inc

  • Massage Therapist
  • Portland, OR
  • NPI 1477368876
  NPD Authorized official
• Valley Isle Chiropractic Inc

  dba Ohana Hale Chiropractic

  • Chiropractor
  • Kahului, HI
  • NPI 1174998710
  NPD (past)
• Valley Isle Chiropractic Inc

  dba Ohana Hale Chiropractic

  • Chiropractor
  • Kahului, HI
  • NPI 1801964390
  NPD (past)

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

{
    "created_epoch": "1345939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1740538628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 SE SALMON ST UNIT A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152577",
            "telephone_number": "808-280-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 SE CLINTON ST STE E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021273",
            "telephone_number": "808-280-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "PETER",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-26",
        "last_updated": "2025-02-12",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24898",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "MAT 2885",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph L Black, MD
• Katherine Rollins Black, MD
• Kevin Black, LICSW
• Margaret Joanna Black, M.D.
• Morgan Black, MD
• Pualani Star Black
• Samantha Black, M.A.
• Steffany Karen Black, MA SCHOOL COUNSELING
• Stephanie Black
• Sugar Ray Black

• 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 Feb 12, 2025; 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.