Jackie Johnson

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

22647 Issued in OR

Practice address

12923 NW Cornell Rd Ste 201
Portland, OR 97229-5834

Phone

(503) 646-3393

Fax

(503) 672-7042

NPI assigned

Sep 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1861940108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12923 NW CORNELL RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295834",
            "telephone_number": "503-646-3393",
            "fax_number": "503-672-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12923 NW CORNELL RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295834",
            "telephone_number": "503-646-3393",
            "fax_number": "503-672-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACKIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "22647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather N Johnson, RN
• Heidi Mae Johnson
• Holly Johnson
• Hope Johnson
• Jacinta Anne Johnson, CNA
• Jalane Johnson, BS
• James (Jim) Charles Johnson, PH.D.
• James C Johnson, MD
• Janee Johnson, M.S. CAP
• Janice Lynne Johnson

• 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 Sep 15, 2016; 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.