Brandin Michelle Thibodeaux, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

11652 Issued in OR

Practice address

21974 NE Highway 240
Newberg, OR 97132-6859

Phone

(503) 550-5083

Fax

(503) 538-3797

NPI assigned

Jul 18, 2006

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Time for Me Professional Massage Therapy LLC

  • Massage Therapist
  • Newberg, OR
  • NPI 1396029914
  NPD (past) Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1871511576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971320222",
            "telephone_number": "503-550-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21974 NE HIGHWAY 240",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971326859",
            "telephone_number": "503-550-5083",
            "fax_number": "503-538-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "BRANDIN",
        "middle_name": "MICHELLE",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "11652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Sarah Tesulov
• Janelle R Thayer-Engle, M.A., L.P.C.
• The Clover Clinic, LLC
• The Radiology Group, P.C.
• Therapeutic Associates Inc (Tai - Newberg)
• Michelle Brannen Thilavanh, PA-C
• Chelsea L Thomas, PSYD
• Saramma Benn Thomas, DDS
• Ryan Thompson, PSY.D
• Joshua David Thoreson, DPT

• Massage Therapist in Newberg, OR
• Providers in Newberg, 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 30, 2011; 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.