Active NPI
Jacquelyn C Pannullo, MS, LMT
- Massage Therapist
- Hood River, OR
National Provider Identifier
1871870956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 16525
- Practice address
- 420 Industrial St
Hood River, OR 97031-2236 - Phone
- (503) 756-6170
- NPI assigned
- Nov 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 16525 | OR | Primary |
Addresses
Primary practice location
420 Industrial St
Hood River, OR 97031-2236
Mailing address
1802 Prospect Ave
Hood River, OR 97031-1365
Phone (503) 756-6170
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16525 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1871870956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 PROSPECT AVE",
"city": "HOOD RIVER",
"state": "OR",
"postal_code": "970311365",
"telephone_number": "503-756-6170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 INDUSTRIAL ST",
"city": "HOOD RIVER",
"state": "OR",
"postal_code": "970312236",
"telephone_number": "503-756-6170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANNULLO",
"first_name": "JACQUELYN",
"middle_name": "C",
"credential": "MS, LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-03",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "16525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hood River, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.