Kaitlyn Douglas, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

25073 Issued in OR

Practice address

7817 SE Stark St
Portland, OR 97215-2339

Phone

(503) 975-5298

Fax

(503) 546-7496

NPI assigned

Sep 10, 2020

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1962017459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3246 NE 49TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131849",
            "telephone_number": "971-270-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7817 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152339",
            "telephone_number": "503-975-5298",
            "fax_number": "503-546-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KAITLYN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "25073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Ray Douglas, M.D.
• David Morrison Douglas, MD
• Edmond Arlen Douglas
• Emelie Angelina Douglas, MA, LPC
• Jae Patricia Douglas, LMSW, PH.D.
• Mackenzie E Douglas, D.M.D.
• Peter Douglas, DDS
• Savanna Douglas
• Shannon B Douglas, RN
• Susan Douglas

• 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 Sep 10, 2020; 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.