JASON ISHMAEL EZZY LMT AHS NPI 1083376396

NPI Information

NPI: 1083376396
Provider Name: JASON ISHMAEL EZZY, LMT, AHS
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
1717 CONGRESS ST STE 3
PORTLAND, ME
ZIP 04102
Phone: (207) 449-2847
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Jason Ishmael Ezzy, LMT, AHS is a massage therapist in Portland, ME. The provider is 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. Jason Ishmael Ezzy, LMT, AHS NPI is 1083376396. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1717 CONGRESS ST STE 3
PORTLAND, ME
ZIP 04102-983
Phone: (207) 449-2847

The enumeration date for this NPI number is 10/13/2021 and was last updated on 10/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		MT4860	MAINE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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