Individual provider Active NPI

Jeremy Daniel Efseaff, L.M.T.

  • Massage Therapist
  • Keizer, OR
National Provider Identifier
1770827693
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
17482 Issued in OR
Practice address
5300 River Rd N
Keizer, OR 97303-4428
Phone
(503) 393-3624
Fax
(503) 393-0108
NPI assigned
Nov 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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 17482 OR Primary

Addresses

Primary practice location

5300 River Rd N
Keizer, OR 97303-4428

Mailing address

1250 Ridgepoint St NE
Keizer, OR 97303-1778
Phone (503) 930-0706

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
17482ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpmbeckmannnror LLC Past Accepting new patients
Advanced Family Eyecare Inc Past Accepting new patients

Organizations & group practices 2

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": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1770827693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 RIDGEPOINT ST NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973031778",
            "telephone_number": "503-930-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034428",
            "telephone_number": "503-393-3624",
            "fax_number": "503-393-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFSEAFF",
        "first_name": "JEREMY",
        "middle_name": "DANIEL",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.