Active NPI
KC Davidson, LMT
- Massage Therapist
- Beaverton, OR
National Provider Identifier
1760417687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 7107
- Practice address
- 3863B SW Hall Blvd
Beaverton, OR 97005 - Phone
- (503) 626-4242
- Fax
- (503) 626-4242
- NPI assigned
- Jul 11, 2006
- Last updated
- Apr 4, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 7107 | OR | Primary |
Addresses
Primary practice location
3863B SW Hall Blvd
Beaverton, OR 97005
Mailing address
3863 B SW Hall Blvd
Beaverton, OR 97005
Phone (503) 626-4242
Other names 1
- Cathie Davidson
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
- Credentials
- Master of Theology
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7107 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396569600000",
"number": "1760417687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3863 B SW HALL BLVD",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97005",
"telephone_number": "503-626-4242",
"fax_number": "503-626-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3863B SW HALL BLVD",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97005",
"telephone_number": "503-626-4242",
"fax_number": "503-626-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "KC",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2014-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "7107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CATHIE",
"last_name": "DAVIDSON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.