Individual provider Active NPI

Fiona C Lacey, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1922645183
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
25012 Issued in OR
Practice address
2927 NE Everett St
Portland, OR 97232-3248
Phone
(503) 232-6161
NPI assigned
Dec 6, 2019
Last updated
Dec 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 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 25012 OR Primary

Addresses

Primary practice location

2927 NE Everett St
Portland, OR 97232-3248

Mailing address

16916 SE Powell Blvd Apt 3
Portland, OR 97236-8709
Phone (802) 387-0811

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
25012ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Everett & Flanders House Community Club Massage Therapist CurrentSince Feb 23, 2020 Accepting new patients

Locations

2927 NE Everett St
Portland, OR 97232
Phone (503) 232-4099

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1922645183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16916 SE POWELL BLVD APT 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972368709",
            "telephone_number": "802-387-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 NE EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323248",
            "telephone_number": "503-232-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY",
        "first_name": "FIONA",
        "middle_name": "C",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "25012",
            "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 Dec 6, 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.