Individual provider Active NPI

Justin Q Egli, BS, LMT

  • Massage Therapist
  • Hillsboro, OR
National Provider Identifier
1952899494
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
LMT-8219 Issued in OR
Practice address
2167 NW 185TH Ave
Hillsboro, OR 97124-7074
Phone
(503) 828-1311
NPI assigned
Apr 30, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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 LMT-8219 OR Primary

Addresses

Primary practice location

2167 NW 185TH Ave
Hillsboro, OR 97124-7074

Mailing address

833 NW Fieldcrest Way Apt S102
Beaverton, OR 97006-8722
Phone (503) 961-2565

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
LMT-8219ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marcotte Studio One Massage Therapist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1952899494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 NW FIELDCREST WAY APT S102",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068722",
            "telephone_number": "503-961-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2167 NW 185TH AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247074",
            "telephone_number": "503-828-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGLI",
        "first_name": "JUSTIN",
        "middle_name": "Q",
        "credential": "BS, LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "LMT-8219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.