Individual provider Active NPI

Klara Louise Ecklund, L.M.T.

  • Mechanotherapist
  • Wilsonville, OR
National Provider Identifier
1992931869
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
16291 Issued in OR
Practice address
25700 SW Argyle Ave
Wilsonville, OR 97070-5799
Phone
(503) 582-9805
NPI assigned
Jun 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 16291 OR Primary

Addresses

Primary practice location

25700 SW Argyle Ave
Wilsonville, OR 97070-5799

Mailing address

25700 SW Argyle Ave
Wilsonville, OR 97070-5799
Phone (503) 582-9805

Other identifiers 1

IdentifierTypeStateIssuer
16291OtherORSTATE LICENSE

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

State licenses

LicenseStateTypeSpecialty
16291ORMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1992931869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25700 SW ARGYLE AVE",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970705799",
            "telephone_number": "503-582-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25700 SW ARGYLE AVE",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970705799",
            "telephone_number": "503-582-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKLUND",
        "first_name": "KLARA",
        "middle_name": "LOUISE",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "16291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "16291",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; 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.