Individual provider Active NPI

Andrea Amanda Gelinske-Shettler, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1831308196
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
10385 Issued in OR
Practice address
10535 NE Glisan St
100
Portland, OR 97220-4077
Phone
(503) 261-1120
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 10385 OR Primary

Addresses

Primary practice location

10535 NE Glisan St
100
Portland, OR 97220-4077

Mailing address

10535 NE Glisan St
Ste 100
Portland, OR 97220-4077
Phone (503) 261-1120

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
10385ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831308196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST",
            "address_2": "STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204077",
            "telephone_number": "503-261-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST",
            "address_2": "100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204077",
            "telephone_number": "503-261-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELINSKE-SHETTLER",
        "first_name": "ANDREA",
        "middle_name": "AMANDA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "10385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; 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.