Active NPI
Mya Michelle Lokan, LMT
- Massage Therapist
- Springfield, OR
National Provider Identifier
1831887009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 25456
- Practice address
- 112 49TH St.
Springfield, OR 97478 - Phone
- (541) 726-6521
- Fax
- (541) 726-1615
- NPI assigned
- Apr 26, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 25456 | OR | Primary |
Addresses
Primary practice location
112 49TH St.
Springfield, OR 97478
Mailing address
46164 Goodpasture Rd.
Vida, OR 97488
Phone (541) 790-9859
Other names 1
- Mya Michelle Carrillo
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25456 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682467200000",
"number": "1831887009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46164 GOODPASTURE RD.",
"city": "VIDA",
"state": "OR",
"postal_code": "97488",
"telephone_number": "541-790-9859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 49TH ST.",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "97478",
"telephone_number": "541-726-6521",
"fax_number": "541-726-1615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOKAN",
"first_name": "MYA",
"middle_name": "MICHELLE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-26",
"last_updated": "2023-04-26",
"certification_date": "2023-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "25456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MYA",
"last_name": "CARRILLO",
"middle_name": "MICHELLE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Springfield, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.