Jennifer L Wyant, LMT, CMMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

18843 Issued in OR

Practice address

1224 SW Morrison St
Portland, OR 97205-2218

Phone

(503) 732-0011

Fax

(678) 666-7128

NPI assigned

Aug 9, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891042784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21131 S JUBB RD",
            "city": "ESTACADA",
            "state": "OR",
            "postal_code": "970238629",
            "telephone_number": "503-732-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 SW MORRISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052218",
            "telephone_number": "503-732-0011",
            "fax_number": "678-666-7128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21131 S Jubb Rd",
            "address_purpose": "LOCATION",
            "city": "Estacada",
            "state": "OR",
            "postal_code": "970238629",
            "country_code": "US",
            "telephone_number": "503-732-0011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYANT",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LMT, CMMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "18843",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "18843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Jane Wurst
• Ursula Wurster
• William Richard Wurster, MD
• Benjamin Wurtsbaugh
• Raghav Wusirika, MD
• Lindsay Evelyn Wyant, PAC
• Nedd L Wyant, RN
• Brittany A Wyas
• Ardyn R Wyatt, LCSW
• Ashley Marie Wyatt

• 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 Mar 17, 2018; 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.