Alissa K Kipp LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

18918 Issued in OR

Legal business name

ALISSA K KIPP LMT

Doing business as

ilo WELLNESS

Practice address

123 NE 6TH Ave
Portland, OR 97232-2903

Phone

(503) 961-4036

NPI assigned

Apr 18, 2016

Last updated

Apr 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alissa K Kipp, LMTNPI 1578096384

Title

Owner

Phone

(503) 961-4036

Specialties & licenses 1

Addresses

Other names 1

• ilo WELLNESS Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alissa K Kipp, LMT

  • Massage Therapist
  • Portland, OR
  • NPI 1578096384
  NPD (past) Authorized official

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1992159875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 NE 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322903",
            "telephone_number": "503-961-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 NE 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322903",
            "telephone_number": "503-961-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALISSA K KIPP LMT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "KIPP",
        "authorized_official_first_name": "ALISSA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-961-4036",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "18918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ilo WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Apr 18, 2016; 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.