Serenity Bodywork

Primary specialty

SpecialistTaxonomy code 174400000X

License

18053 Issued in OR

Legal business name

SERENITY BODYWORK

Practice address

15962 Boones Ferry Rd
Suite 202
Lake Oswego, OR 97035-4351

Phone

(503) 860-2372

NPI assigned

Sep 24, 2014

Organization subpart

No

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

Authorized official

Name

Mandy Jean Beeman, LMT

Title

Owner

Phone

(503) 860-2372

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1891197505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15962 BOONES FERRY RD",
            "address_2": "SUITE 202",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354351",
            "telephone_number": "503-860-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15962 BOONES FERRY RD",
            "address_2": "SUITE 202",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354351",
            "telephone_number": "503-860-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY BODYWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "BEEMAN",
        "authorized_official_first_name": "MANDY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-860-2372",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "18053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1669711131",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.