Individual provider Active NPI

Tatiana Mouton

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1891635702
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27209 Issued in OR
Practice address
5020 NE Martin Luther King Blvd
Portland, OR 97211-3204
Phone
(503) 902-1122
NPI assigned
Mar 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 27209 OR Primary

Addresses

Primary practice location

5020 NE Martin Luther King Blvd
Portland, OR 97211-3204

Mailing address

5020 NE Martin Luther King Blvd
Portland, OR 97211-3204
Phone (503) 902-1122

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
27209ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1891635702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 NE MARTIN LUTHER KING BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113204",
            "telephone_number": "503-902-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 NE MARTIN LUTHER KING BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113204",
            "telephone_number": "503-902-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTON",
        "first_name": "TATIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "27209",
            "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 30, 2026; 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.