Active NPI
Mariah Talicuran
- Massage Therapist
- Portland, OR
National Provider Identifier
1740734110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21183
- Practice address
- 3912 N Mississippi Ave
Portland, OR 97227-1163 - Phone
- (971) 703-4347
- NPI assigned
- Aug 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 21183 | OR | Primary |
Addresses
Primary practice location
3912 N Mississippi Ave
Portland, OR 97227-1163
Mailing address
1717 SW Park Ave
1023
Portland, OR 97201-3267
Phone (360) 607-9416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21183 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471219200000",
"number": "1740734110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 SW PARK AVE",
"address_2": "1023",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972013267",
"telephone_number": "360-607-9416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3912 N MISSISSIPPI AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271163",
"telephone_number": "971-703-4347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALICURAN",
"first_name": "MARIAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-15",
"last_updated": "2016-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "21183",
"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 15, 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.