ELISA BROCKWAY (NPI# 1164040333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164040333 |
| Entity Type | Individual |
| Full Name | ELISA BROCKWAY |
| Credential | LMT |
| Practice Address |
530 1st St Ste B2 Lake Oswego OR 97034-3248 |
| Mailing Address |
1605 Ne 76th Ave Portland OR 97213-6747 |
| Practice Telephone | 9713444223 |
| Mailing Telephone | 9713444223 |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 7964 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
530 1ST ST STE B2 |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97034-3248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194377309 | Robin Donart | Case Manager/Care Coordinator | 2595 Christie Drive, Lake Oswego, OR 97034 | 2019-07-09 |
| 1740844539 | New Avenues for Youth | Clinic/Center | 2595 Christie Dr., Lake Oswego, OR 97034 | 2019-04-26 |
| 1366946451 | Kristy Car Makowichuk | Counselor | 630 B Avenue, Suite 9, Lake Oswego, OR 97034 | 2018-03-22 |
| 1861841504 | Soaring Crane Acuouncture LLC | Acupuncturist | 630 B Ave. #3, Lake Oswego, OR 97034 | 2016-06-03 |
| 1679945216 | Guru Sandesh Singh Khalsa | Naturopath | 630 B Avenue, Suite 3, Lake Oswego, OR 97034 | 2015-10-22 |
| 1902208846 | 360 Pediatric Psychology, PC | Clinical Neuropsychologist | 201 B Ave., Suite #285, Lake Oswego, OR 97034 | 2014-09-23 |
| 1275873309 | Sara Elizabeth Forrest | Social Worker | 2507 Christie Dr., Lake Oswego, OR 97034 | 2013-02-27 |
| 1982964631 | Catherine L Morris Daraee | Social Worker | 4040 Douglas Way, Lake Oswego, OR 97034 | 2012-05-29 |
| 1205105244 | Gail E. Barnard | Specialist/Technologist | 1260 Rockinghorse Ln, Lake Oswego, OR 97034 | 2011-12-20 |
| 1306099460 | Corinne Jarvis | Speech-Language Pathologist | 325 3rd Street, Lake Oswego, OR 97034 | 2008-11-02 |
| Find all providers in zip 97034 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437795549 | Yan Li | Massage Therapist | 16624 Roosevelt Ave, Lake Oswego, OR 97035-4046 | 2019-11-24 |
| 1972157931 | Xiaoyue O Chin | Massage Therapist | 459 2nd St, Lake Oswego, OR 97034-3126 | 2019-07-29 |
| 1437718764 | Richard C Irvine Jr. | Massage Therapist | 3 Monroe Pkwy Ste 100u, Lake Oswego, OR 97035-1486 | 2019-06-11 |
| 1295214609 | Valencia Arciniega | Massage Therapist | 311 B Ave Ste W, Lake Oswego, OR 97034-3071 | 2018-08-08 |
| 1063914299 | Jessica Gaisford | Massage Therapist | 4 Monroe Pkwy Ste J, Lake Oswego, OR 97035-1406 | 2018-03-03 |
| 1457851149 | Daniel Kler | Massage Therapist | 15110 Boones Ferry Rd Ste 100c, Lake Oswego, OR 97035-3452 | 2018-02-19 |
| 1295243350 | Jenney Lanae Seale | Massage Therapist | 15110 Boones Ferry Rd Ste 100, Lake Oswego, OR 97035-3468 | 2018-01-11 |
| 1679082622 | Callie Albertus | Massage Therapist | 16679 Boones Ferry Rd Ste 105, Lake Oswego, OR 97035-4378 | 2017-09-21 |
| 1114436250 | David Holloway | Massage Therapist | 17777 Lower Boones Ferry Rd, Lake Oswego, OR 97035-5398 | 2017-09-20 |
| 1770958035 | Hannah Lyons | Massage Therapist | 16088 Boones Ferry Rd, Suite B, Lake Oswego, OR 97035-4370 | 2015-12-11 |
| Find all providers in LAKE OSWEGO | ||||
| City | LAKE OSWEGO |
| Zip Code | 97034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.