Blake WP Fraser, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

26427 Issued in OR

Practice address

1125 SE Division St Ste 204
Portland, OR 97202-2567

Phone

(682) 622-6602

NPI assigned

Sep 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1851907018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 SE DIVISION ST STE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022567",
            "telephone_number": "682-622-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SE DIVISION ST STE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022567",
            "telephone_number": "682-622-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "BLAKE",
        "middle_name": "WP",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-22",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "26427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Blakefraser@fullyrestoredmassage.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10983 Bluffside Dr Apt 6218",
            "city": "Studio City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "916044472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daisy A Franzini, M.D.
• Andrea Melina Frasca, MA
• Allison Marie Fraser, QMHP
• Andrea Marie Fraser, D.D.S
• Andrew Fraser
• Jessica Marie Fraser
• Kameryn Marie Fraser
• Katherine Lynn Fraser, B.S.
• Christina Elizabeth Fratangelo, ACNP
• Jaymee Frate

• 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 Feb 1, 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.