Individual provider Active NPI

Diana Vasilauskas, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1740922194
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7603 Issued in OR
Practice address
1611 SE Bybee Blvd
Portland, OR 97202-5752
Phone
(971) 279-5638
Fax
(866) 473-0398
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 7603 OR Primary

Addresses

Primary practice location

1611 SE Bybee Blvd
Portland, OR 97202-5752

Mailing address

3425 SE Barba St
Milwaukie, OR 97222-5530
Phone (503) 957-5926

Other names 1

  • Magidah Crow Professional name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ritualuna Wellness LLC Single Specialty CurrentSince Apr 1, 2022 Accepting new patients

Locations

1611 SE Bybee Blvd
Portland, OR 97202
Phone (503) 572-9234

6637 SE Milwaukie Ave
Ste 207
Portland, OR 97202
Phone (541) 653-1341

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1740922194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 SE BARBA ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972225530",
            "telephone_number": "503-957-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 SE BYBEE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025752",
            "telephone_number": "971-279-5638",
            "fax_number": "866-473-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILAUSKAS",
        "first_name": "DIANA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "7603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGIDAH",
            "last_name": "CROW",
            "credential": "LMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Dec 3, 2024; 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.