Marissa C Dorry, LMT
Individual provider Active NPI Massage Therapist · Portland, OR
NPI 1982244620 · NPPES record last updated Jan 10, 2020
Key facts
- NPI
- 1982244620
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 21742 (OR)
- Practice address
- 2927 NE Everett St
Portland, OR 97232-3248 - Phone
- (505) 232-6161
- NPI assigned
- Jan 10, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21742 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Everett & Flanders House Community Club | Massage Therapist | Current |
Accepting new patients |
Locations
2927 NE Everett St
Portland, OR 97232
Phone (503) 232-4099
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 21742 | OR | Yes |
Addresses
Primary practice location
2927 NE Everett St
Portland, OR 97232-3248
Mailing address
2927 NE Everett St
Portland, OR 97232-3248
Phone (503) 232-6161
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.