Individual provider Active NPI

Janelle Lee Douglass

  • Massage Therapist
  • Salem, OR
National Provider Identifier
1902398886
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
19968 Issued in OR
Practice address
4356 Commercial St SE
Salem, OR 97302-3914
Phone
(503) 689-1216
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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 19968 OR Primary

Addresses

Primary practice location

4356 Commercial St SE
Salem, OR 97302-3914

Mailing address

2195 Turnage St NW
Salem, OR 97304-4520
Phone (541) 915-5648

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
19968ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Valley Wellness LLC Massage Therapist PastSince Apr 3, 2014 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.

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1902398886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 TURNAGE ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044520",
            "telephone_number": "541-915-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4356 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973023914",
            "telephone_number": "503-689-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "JANELLE",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.