NPIMap

Individual provider Active NPI

Jennifer Bowler Laroche, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1780951558
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
11957 Issued in OR
Practice address
1928 NE 40TH Ave
Portland, OR 97212-5310
Phone
(503) 287-2787
NPI assigned
Nov 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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 11957 OR Primary

Addresses

Primary practice location

1928 NE 40TH Ave
Portland, OR 97212-5310

Mailing address

7443 SW 31St Ave
Portland, OR 97219-1810
Phone (503) 484-4286

Other names 1

  • Jennifer Rose Bowler-Laroche 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

State licenses

LicenseStateTypeSpecialty
11957ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spa Willamina Massage Therapist Past Accepting new patients
Phoenix Services, Inc. Massage Therapist 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": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1780951558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7443 SW 31ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191810",
            "telephone_number": "503-484-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 NE 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125310",
            "telephone_number": "503-287-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROCHE",
        "first_name": "JENNIFER",
        "middle_name": "BOWLER",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "11957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BOWLER-LAROCHE",
            "middle_name": "ROSE",
            "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 Nov 22, 2011; 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.