Laurel White Wolfe Surles, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

17485 Issued in OR

Practice address

15435 SW Gleneden Dr
Beaverton, OR 97007-5968

Phone

(503) 894-4888

NPI assigned

Sep 1, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Laurel Wolfe Surles Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Theology

State licenses

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1801103569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15435 SW GLENEDEN DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970075968",
            "telephone_number": "503-894-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15435 SW GLENEDEN DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970075968",
            "telephone_number": "503-894-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE SURLES",
        "first_name": "LAUREL",
        "middle_name": "WHITE",
        "name_prefix": "Mrs.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "WOLFE SURLES",
            "credential": "L.M.T.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.