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Danielle Lee Tkacik , LMT

Massage Therapist β€’ Gresham, OR

Active NPI 1932840535 Individual Practitioner Female Practitioner
Practice location in NPPES

1733 E Powell Blvd Ste 102
Gresham, OR 970308013

Call 5037406343 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1733 E Powell Blvd Ste 102

Gresham, OR 970308013

Telephone 5037406343
Fax 5039743744
Organization at the Same NPPES Address or Phone
Soully Aware Llc Facility NPI 1780448878

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 3 distinct additional practice-address records in Estacada, OR; Portland, OR; Wood Village, OR. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2022

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Gresham and Oregon

127 active clinicians are listed under Massage Therapist with a practice address in Gresham, OR (6,086 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gresham

0% of these 127 clinicians have the CMS telehealth indicator.

0% of these 127 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-05-07
Massage Therapist Primary Specialty

NUCC Taxonomy Code: 225700000X

License # reported to NPPES OR 26808

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Group Npi
1780448878

Secondary Practice Locations

1110 Ne Wood Village Blvd Ste 23

Wood Village, OR 970602668

Phone: 5037406343

1722 Nw Raleigh St Ste 417

Portland, OR 972091753

Phone: 5037406343

335 S Broadway St

Estacada, OR 97023

Phone: 5037406343

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location May 14, 2024

Registered at 1733 E POWELL BLVD STE 102, GRESHAM, OR 970308013 (Tel: 5037406343)

πŸ“
Updated Business Mailing Address May 14, 2024

Registered at 1733 E POWELL BLVD STE 102, GRESHAM, OR 970308013 (Tel: 5037406343)

πŸ“
Updated Practice Location February 03, 2024

Registered at 1110 NE WOOD VILLAGE BLVD STE 23, WOOD VILLAGE, OR 970602668 (Tel: 5037406343)

βœ…
NPI Profile Active April 07, 2022

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 07, 2022

Registered at 3716 SE INTERNATIONAL WAY, MILWAUKIE, OR 972226001 (Tel: 5036590073)

πŸ“
Business Mailing Address (Initial Record) April 07, 2022

Registered at 37603 RACHAEL DR, SANDY, OR 970556331 (Tel: 5035229229)

πŸ‘€
Provider Name / Credentials (Initial Record) April 07, 2022

Recorded as DANIELLE TKACIK, LMT

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 07, 2022

Massage Therapist (license number reported to NPPES: OR 26808)

🟒
Initial NPI Registration & Enumeration April 06, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1932840535
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 06, 2022
Last Update: May 14, 2024
Sole Proprietor: Yes

Mailing Address

1733 E Powell Blvd Ste 102

Gresham, OR 970308013

Phone: 5037406343

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.