NPIMap

Organization Active NPI

Freebert Studio, LLC

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1861897589
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
20918 Issued in OR
Legal business name
FREEBERT STUDIO, LLC
Practice address
5905 NE 15TH Ave
Portland, OR 97211-4940
Phone
(503) 809-1085
NPI assigned
Oct 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
Mrs. Mary Theresa Ebert, LMTNPI 1851796601
Title
Licensed Massage Therapist
Phone
(503) 809-1085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 20918 OR Primary

Addresses

Primary practice location

5905 NE 15TH Ave
Portland, OR 97211-4940

Mailing address

5905 NE 15TH Ave
Portland, OR 97211-4940
Phone (503) 809-1085

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1861897589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 NE 15TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972114940",
            "telephone_number": "503-809-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 NE 15TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972114940",
            "telephone_number": "503-809-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEBERT STUDIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "THERESA",
        "authorized_official_title_or_position": "LICENSED MASSAGE THERAPIST",
        "authorized_official_telephone_number": "503-809-1085",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "20918",
            "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 Nov 4, 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.