Individual provider Active NPI

Denise Marie Moore, LMT

  • Massage Therapist
  • Astoria, OR
National Provider Identifier
1770118721
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
25155 Issued in OR
Practice address
818 Commercial St Ste 306
Astoria, OR 97103-4553
Phone
(503) 468-9606
NPI assigned
Mar 10, 2020
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 25155 OR Primary

Addresses

Primary practice location

818 Commercial St Ste 306
Astoria, OR 97103-4553

Mailing address

43540 Sylvandale LN
Astoria, OR 97103-8406
Phone (503) 468-9606

Other practice location 1

43540 Sylvandale Ln
Astoria, OR 97103-8406
Phone (503) 468-9606

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

LicenseStateTypeSpecialty
25155ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Serenity Massage LLC Massage Therapist PastSince Mar 1, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1770118721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43540 SYLVANDALE LN",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971038406",
            "telephone_number": "503-468-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 COMMERCIAL ST STE 306",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971034553",
            "telephone_number": "503-468-9606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43540 Sylvandale Ln",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "OR",
            "postal_code": "971038406",
            "country_code": "US",
            "telephone_number": "503-468-9606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "25155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.