Active NPI
Justin Friend, LMT
- Massage Therapist
- Tualatin, OR
National Provider Identifier
1912216185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 17230
- Practice address
- 7052 SW Nyberg St
Tualatin, OR 97062 - Phone
- (503) 691-7788
- NPI assigned
- Oct 5, 2010
- Sex
- Male
- 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 | 17230 | OR | Primary |
Addresses
Primary practice location
7052 SW Nyberg St
Tualatin, OR 97062
Mailing address
7052 SW Nyberg Street
Tualatin, OR 97062
Phone (503) 691-7788
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17230 | Other | OR | STATE OF OREGON, BOARD OF MASSAGE THERAPIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304035200000",
"number": "1912216185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7052 SW NYBERG STREET",
"city": "TUALATIN",
"state": "OR",
"postal_code": "97062",
"telephone_number": "503-691-7788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7052 SW NYBERG ST",
"city": "TUALATIN",
"state": "OR",
"postal_code": "97062",
"telephone_number": "503-691-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEND",
"first_name": "JUSTIN",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-05",
"last_updated": "2011-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "17230",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF OREGON, BOARD OF MASSAGE THERAPIST",
"identifier": "17230",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.