NPI 1376213272 · live from the CMS NPI Registry
Jim Karl Anderson
Massage Therapist in Portland, OR. National Provider Identifier 1376213272, active.
NPI record
| NPI | 1376213272 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 2505 Sw Spring Garden St Ste 100, Portland, OR 97219 |
| Practice phone | 503-841-6222 |
| Mailing address | 5410 Sw 42nd Ave, Portland, OR 97221 |
| Enumerated | September 14, 2021 |
| Last updated | September 14, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 26107 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.