Active NPI
Ulric Shawn Legouest, LMT
- Massage Therapist
- Gresham, OR
National Provider Identifier
1770937740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21816
- Practice address
- 22400 SE Stark St # 105
Gresham, OR 97030-2656 - Phone
- (503) 907-0099
- NPI assigned
- Apr 15, 2016
- Sex
- Male
- 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 | 21816 | OR | Primary |
Addresses
Primary practice location
22400 SE Stark St # 105
Gresham, OR 97030-2656
Mailing address
12530 SE Market St
Portland, OR 97233-1241
Phone (503) 314-1722
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 |
|---|---|---|---|
| 21816 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460678400000",
"number": "1770937740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12530 SE MARKET ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331241",
"telephone_number": "503-314-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22400 SE STARK ST # 105",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970302656",
"telephone_number": "503-907-0099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGOUEST",
"first_name": "ULRIC",
"middle_name": "SHAWN",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-15",
"last_updated": "2016-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "21816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.