Restore Massage PDX LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

17822 Issued in OR

Legal business name

RESTORE MASSAGE PDX LLC

Practice address

14833 SW 72ND Ave
Tigard, OR 97224-7911

Phone

(971) 570-1495

NPI assigned

Apr 27, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Ashley N Reagan

Title

Licensed Massage Therapist

Phone

(971) 570-1495

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1740635713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14833 SW 72ND AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247911",
            "telephone_number": "971-570-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14833 SW 72ND AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247911",
            "telephone_number": "971-570-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE MASSAGE PDX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "REAGAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "LICENSED MASSAGE THERAPIST",
        "authorized_official_telephone_number": "971-570-1495",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "OR",
            "license": "17822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Tigard, OR
• Providers in Tigard, OR by specialty
• Point of Service in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.