Karin E Wagner, CERTIFIED ROLFER LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

11497 Issued in OR

Practice address

2732 SE 18TH Ave
Portland, OR 97202-2265

Phone

(503) 230-0087

NPI assigned

Sep 4, 2007

Last updated

Nov 20, 2012By the provider in NPPES

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

• Karin N Edwards Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1851585608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2732 SE 18TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022265",
            "telephone_number": "503-230-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2732 SE 18TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022265",
            "telephone_number": "503-230-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KARIN",
        "middle_name": "E",
        "credential": "CERTIFIED ROLFER LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "11497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARIN",
            "last_name": "EDWARDS",
            "middle_name": "N",
            "credential": "CERTIFIED ROLFER LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fiona Grace Wagner, L.M.T
• Fredrick Charles Wagner, MD
• Jeffrey David Wagner, DNP, ARNP
• Jessica Wagner, LICSW
• Juniper Elizabeth Wagner
• Kathryn Wagner, MD
• Katje Wagner, PHD, LPC
• Nan Nelson Wagner, RRT
• Robert Frederick Wagner, D.M.D.
• Stephanie Nicole Wagner

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.