BACK TO THE SOURCE (NPI# 1942718952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942718952 |
| Entity Type | Organization |
| Organization Name | BACK TO THE SOURCE |
| Other Organization Name | BACK TO THE SOURCE |
| Practice Address |
823 Ne Broadway St Portland OR 97232-1215 |
| Practice Telephone | 5038928787 |
| Mailing Telephone | 5038928787 |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |
| Authorized Official Name | JULIE ROBINSON (OWNER) |
| Authorized Official Telephone | 5038928787 |
| Authorized Official Credential | LMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Back to the Source | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | BACK TO THE SOURCE | 823 Ne Broadway, Portland, OR 97232 |
| Oregon Corporations, Companies and Business Names | BACK TO THE SOURCE, LLC | 823 Ne Broadway St, Portland, OR 97232 |
| Street Address |
823 NE BROADWAY ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710930342 | Julie K Robinson | Massage Therapist | 823 Ne Broadway St, Portland, OR 97232-1215 | 2006-05-17 |
| 1528514684 | Sarah Ej Hall | Contractor | 823 Ne Broadway St, Portland, OR 97232-1215 | 2016-08-29 |
| 1952579625 | Abe Cohen Dc PC | Chiropractor | 823 Ne Broadway St, Portland, OR 97232-1215 | 2008-02-15 |
| 1821120387 | Judith L. Butler | Counselor | 823 Ne Broadway St, Portland, OR 97232-1215 | 2007-03-11 |
| 1346397502 | Laurie J. Cox | Social Worker | 823 Ne Broadway St, Suite 2b, Portland, OR 97232-1215 | 2007-01-03 |
| 1760541205 | Gabriella Elise Donnell | Social Worker | 823 Ne Broadway St, Portland, OR 97232-1215 | 2006-12-08 |
| 1285704718 | Abraham J Cohen | Chiropractor | 823 Ne Broadway St, Portland, OR 97232-1215 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
| 1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
| 1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
| 1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
| 1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
| 1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
| Find all providers in zip 97232 | ||||
| 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 |
|---|---|---|---|---|
| 1063013712 | Gabriel Henriques | Massage Therapist | 805 Se Peacock Ln, Portland, OR 97214-3278 | 2020-11-07 |
| 1871193490 | Heather R Anderson | Massage Therapist | 1646 Se Tenino St, Portland, OR 97202-6713 | 2020-11-01 |
| 1205435716 | Michella Onnis | Massage Therapist | 2410 Se 10th Ave, Portland, OR 97214-4624 | 2020-10-26 |
| 1063019479 | Kevin Thomas Ryan | Massage Therapist | 2220 Nw Front Ave Apt 316, Portland, OR 97209-1998 | 2020-10-08 |
| 1497352389 | Nikki Nesta | Massage Therapist | 7849 Se Monroe St, Portland, OR 97222-1158 | 2020-10-05 |
| 1518574953 | Jessica Rose Hobbs | Massage Therapist | 1515 Sw Jefferson St Apt 15, Portland, OR 97201-6064 | 2020-09-29 |
| 1295340057 | Shane Dylan Adair | Massage Therapist | 2934 Se Stephens St, Portland, OR 97214-4960 | 2020-09-09 |
| 1518579416 | Scott Schwartz | Massage Therapist | 4425 S Corbett Ave, Portland, OR 97239-4260 | 2020-08-20 |
| 1134747074 | Katrina Hubbard | Massage Therapist | 1515 Sw 5th Ave, Portland, OR 97201-5406 | 2020-07-07 |
| 1407474539 | Kirstin Hoops | Massage Therapist | 1531 N Webster St, Portland, OR 97217-3752 | 2020-07-06 |
| Find all providers in PORTLAND | ||||
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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.