Active NPI
Andrew Wung
- Massage Therapist
- Portland, OR
National Provider Identifier
1871209676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 27154
- Practice address
- 1617 NE 17TH Ave
Portland, OR 97232-3561 - Phone
- (503) 659-1212
- NPI assigned
- Jan 25, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 27154 | OR | Primary |
Addresses
Primary practice location
1617 NE 17TH Ave
Portland, OR 97232-3561
Mailing address
21841 NE Larkspur LN
Fairview, OR 97024-6785
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27154 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1871209676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21841 NE LARKSPUR LN",
"city": "FAIRVIEW",
"state": "OR",
"postal_code": "970246785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 NE 17TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972323561",
"telephone_number": "503-659-1212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUNG",
"first_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-25",
"last_updated": "2023-01-25",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "27154",
"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 Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.