Individual provider Active NPI

Shaunna Diann Stelzenmueller, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1952731291
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
12815 Issued in OR
Practice address
10915 SE Stark St
Portland, OR 97216-3348
Phone
(503) 261-1120
NPI assigned
Nov 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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 12815 OR Primary

Addresses

Primary practice location

10915 SE Stark St
Portland, OR 97216-3348

Mailing address

1932 SE 100TH Ave
Portland, OR 97216-2618
Phone (503) 929-3115

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
12815ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1385164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1952731291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 SE 100TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162618",
            "telephone_number": "503-929-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163348",
            "telephone_number": "503-261-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELZENMUELLER",
        "first_name": "SHAUNNA",
        "middle_name": "DIANN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-23",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "12815",
            "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 Nov 26, 2013; 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.