Vicky Brooks LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

17835 Issued in OR

Legal business name

VICKY BROOKS LLC

Practice address

4876 NW Bethany Blvd
L-1
Portland, OR 97229-9259

Phone

(847) 721-7579

NPI assigned

Oct 1, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Vicky Brooks, L.M.T.

Title

Massage Therapist

Phone

(847) 721-7579

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1790036713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5387 NW PREAKNESS TER",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4876 NW BETHANY BLVD",
            "address_2": "L-1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972299259",
            "telephone_number": "847-721-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICKY BROOKS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "VICKY",
        "authorized_official_title_or_position": "MASSAGE THERAPIST",
        "authorized_official_telephone_number": "847-721-7579",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.M.T."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.

Verify at the official NPI Registry.