Individual provider Active NPI

Kim Le, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1891254678
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
15294 Issued in OR
Practice address
1500 NW 18TH Ave
Portland, OR 97209-2557
Phone
(971) 227-8316
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 15294 OR Primary

Addresses

Primary practice location

1500 NW 18TH Ave
Portland, OR 97209-2557

Mailing address

8155 SW Piute CT
Tualatin, OR 97062-6301
Phone (971) 227-8316

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

LicenseStateTypeSpecialty
15294ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1891254678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8155 SW PIUTE CT",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970626301",
            "telephone_number": "971-227-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NW 18TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092557",
            "telephone_number": "971-227-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "KIM",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "15294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.