Active NPI
Kidist Adane
- Massage Therapist
- Portland, OR
National Provider Identifier
1932915519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 27389
- Practice address
- 8375 SW Beaverton Hillsdale Hwy Ste 100
Portland, OR 97225-2252 - Phone
- (503) 469-9818
- NPI assigned
- Dec 9, 2024
- Last updated
- Dec 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 27389 | OR | Primary |
Addresses
Primary practice location
8375 SW Beaverton Hillsdale Hwy Ste 100
Portland, OR 97225-2252
Mailing address
14650 NW Cornell Rd Apt 6
Portland, OR 97229-7425
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
| License | State | Type | Specialty |
|---|---|---|---|
| 27389 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sawubona, LLC | Past | 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, 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": "1733702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1932915519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14650 NW CORNELL RD APT 6",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972297425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8375 SW BEAVERTON HILLSDALE HWY STE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972252252",
"telephone_number": "503-469-9818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADANE",
"first_name": "KIDIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-09",
"last_updated": "2024-12-09",
"certification_date": "2024-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "27389",
"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 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.