Massage in Central Oregon LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

MASSAGE IN CENTRAL OREGON LLC

Practice address

57031 Ponderosa Road
BLD 27 Ste M2
Sunriver, OR 97707

Phone

(808) 280-1776

NPI assigned

May 1, 2023

Last updated

Apr 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Stefan Dauteuil, LMTNPI 1841919503

Title

Owner

Phone

(808) 280-1776

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stefan D'Auteuil

  • Massage Therapist
  • Sunriver, OR
  • NPI 1841919503
  NPD Authorized official

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1811686454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16675 MASTEN MILL DR",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977398708",
            "telephone_number": "808-280-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57031 PONDEROSA ROAD",
            "address_2": "BLD 27 STE M2",
            "city": "SUNRIVER",
            "state": "OR",
            "postal_code": "97707",
            "telephone_number": "808-280-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSAGE IN CENTRAL OREGON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-01",
        "last_updated": "2024-04-09",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "DAUTEUIL",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-280-1776",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• I Scott Hall, M.D.
• High Desert Therapy Associates Inc (La Pine Physical Therapy)
• Robert Edward Lee
• Jason Arnie Leistad, L.AC.
• Kevin V. Lemley, M.D.
• Emily Hanne Mattson
• Jennifer McFall, LMT
• Thomas Timmons McGranahan Sr., MD
• Casey O'Neill, D.D.S, M.S.
• Rebound Physical Therapy II, LLC (Rebound Physical Therapy)

• Massage Therapist in Sunriver, OR
• Providers in Sunriver, 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 9, 2024; 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.