Active NPI
Jillian Eberhard
- Massage Therapist
- Lake Oswego, OR
National Provider Identifier
1891189379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21029
- Practice address
- 3 Monroe Pkwy
Suite U
Lake Oswego, OR 97035-1486 - Phone
- (503) 387-3205
- NPI assigned
- Mar 24, 2015
- Sex
- Female
- 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 | 21029 | OR | Primary |
Addresses
Primary practice location
3 Monroe Pkwy
Suite U
Lake Oswego, OR 97035-1486
Mailing address
22975 SW Erio PL
Tualatin, OR 97062-7375
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 |
|---|---|---|---|
| 21029 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RF Heikens Enterprises, Inc | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Massage Therapist
- Lake Oswego, OR
- NPI 1124454160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427155200000",
"number": "1891189379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22975 SW ERIO PL",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970627375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 MONROE PKWY",
"address_2": "SUITE U",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970351486",
"telephone_number": "503-387-3205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERHARD",
"first_name": "JILLIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-24",
"last_updated": "2015-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "21029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.