NPIMap

Organization Active NPI

Nystrom Theraputic Massage

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1982924841
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
11353 Issued in OR
Legal business name
NYSTROM THERAPUTIC MASSAGE
Practice address
9900 SW Wilshire St Ste 190-E
Portland, OR 97225-5035
Phone
(503) 756-9076
Fax
(503) 297-3827
NPI assigned
Jun 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2013

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

Authorized official

Name
Mr. Yarley Nystrom, L.M.T.NPI 1992927792
Title
Owner
Phone
(503) 756-9076

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 11353 OR Primary

Addresses

Primary practice location

9900 SW Wilshire St Ste 190-E
Portland, OR 97225-5035

Mailing address

9900 SW Wilshire St Ste 190-E
Portland, OR 97225-5035
Phone (503) 756-9076

National Provider Directory

National Provider Directory

Locations

9900 SW Wilshire St
Ste 190E
Portland, OR 97225
Phone (503) 756-9076

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369353600000",
    "number": "1982924841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SW WILSHIRE ST STE 190-E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255035",
            "telephone_number": "503-756-9076",
            "fax_number": "503-297-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 SW WILSHIRE ST STE 190-E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255035",
            "telephone_number": "503-756-9076",
            "fax_number": "503-297-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYSTROM THERAPUTIC MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2013-05-24",
        "status": "A",
        "authorized_official_last_name": "NYSTROM",
        "authorized_official_first_name": "YARLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-756-9076",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.M.T."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "11353",
            "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 May 24, 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.