Gresham Balance Body Works LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

13478 Issued in OR

Legal business name

GRESHAM BALANCE BODY WORKS LLC

Practice address

22400 SE Stark St
Gresham, OR 97030

Phone

(541) 510-8476

Fax

(503) 907-0098

NPI assigned

Jul 17, 2012

Last updated

Oct 24, 2014By 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

Lindsay LindalaNPI 1962678755

Title

Owner

Phone

(541) 510-8476

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lindsay Wells, LMT Former legal business name

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.

• Lindsay Jean Lindala, LMT

  • Massage Therapist
  • Gresham, OR
  • NPI 1962678755
  Authorized official Same address or phone

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1841545837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22400 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302656",
            "telephone_number": "541-510-8476",
            "fax_number": "503-907-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22400 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "541-510-8476",
            "fax_number": "503-907-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRESHAM BALANCE BODY WORKS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "LINDALA",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-510-8476"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "13478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1962678755",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lindsay Wells, LMT",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jamey Green, RDH, EPDH
• Shantika Green, LCSW
• Bryan James Greenaway, AU.D.
• Greene & Westermeyer PC
• Gregory Gullo MD PC (Integrated Spine Care)
• Gresham DG LLC
• Gresham Downtown Dental Group, P.C.
• Gresham Family Dentistry, PC
• Gresham Internal Medicine Clinic
• Gresham Modern Dentistry, PC

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

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