Ethan W Trevino, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

26242 Issued in OR

Practice address

5253 NE Sandy Blvd
Portland, OR 97213-2562

Phone

(503) 893-5131

NPI assigned

Feb 26, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cascade Spine & Injury Center, LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1326369398
  NPD

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1942894290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64770 BIG BUCK DR",
            "city": "DEER ISLAND",
            "state": "OR",
            "postal_code": "970549418",
            "telephone_number": "801-686-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5253 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132562",
            "telephone_number": "503-893-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "ETHAN",
        "middle_name": "W",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "26242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Lee Trentadue, LPTA
• Isabelle Trepiccione, M.D.
• Melanie Treuhaft, PROF COUNS ASSOCIATE
• Nori Alea Trevarthen, FNP
• Christina Trevino, MD
• Marie Trevisan, OTR/L
• Sophia Treyger, LPC
• Susan Margaret Trezise
• TRG, LLC
• Tri-Care Wheel Chair Services Inc

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.