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SHANE STARK MEDICAL MASSAGE LMT
NPI 1205593191
Massage Therapist in Portland, OR

Active since November 26, 2021
6700 E BURNSIDE ST, PORTLAND, OR 97215(503) 627-7243 Get Directions Write a Review

NPPES record last updated: November 26, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shane Stark Medical Massage Lmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE STARK MEDICAL MASSAGE LMT (NPI 1205593191) is an individual massage therapist in Portland, Oregon, licensed in Oregon (19432) and active in the NPI registry since November 2021.

NPPES Registry Identity

NPI1205593191
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameSHANE STARKCredential: MEDICAL MASSAGE LMT
Location Address6700 E BURNSIDE STPortland, OR 97215-1051
Mailing Address6700 E Burnside StPortland, OR 97215-1051 · (503) 627-7243
Phone(503) 627-7243
Sole ProprietorNo
Enumeration DateNovember 26, 2021
NPPES CertifiedNovember 26, 2021
✔ NPI 1205593191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in OR · 19432
Definition
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.
6700 E BURNSIDE ST, Portland, OR 97215
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Other Identifiers 1

Other19432OR · 19432

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Stark's NPI number?

The NPI number for Shane Stark is 1205593191. It was assigned to this individual provider in the NPPES registry on November 26, 2021.

Where is Shane Stark located?

Shane Stark practices at 6700 E Burnside St, Portland, OR 97215. The listed phone number is (503) 627-7243.

What is Shane Stark's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Shane Stark was last updated on November 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.