IndividualActive
David Derosia, LMT
NPI 1831497569 · Massage Therapist · Portland, OR
Provider details
- NPI number
- 1831497569
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- License
- 16541 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2143 Ne Broadway St Ste 1
Portland, OR 97232-1512
Phone: (971) 303-8367
Street-level locationGet directions
Mailing address
2143 Ne Broadway St Ste 1
Portland, OR 97232-1512
Additional practice locations (1)
- 2304 E Burnside St Ste 1Portland, OR 97214-1677Phone: (971) 303-8367
Registry dates
- Enumerated
- 2011-03-03
- Last updated
- 2021-04-07
- Certified
- 2021-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.