Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1164547634 Individual Practitioner Female Practitioner

Jennifer Marie Boom , LMT

Massage Therapist • Gresham, OR

Professional Overview & Biography Verified Profile Summary

Jennifer Boom, LMT is a registered healthcare professional specializing in Massage Therapist in Gresham, OR. Practice services are available at 24850 SE STARK ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

24850 Se Stark St
Suite 200

Gresham, OR 970308316

Telephone 5033102622
Associated Practice Facility / Clinic
🏢 Calcagno Pediatrics Pc Facility NPI 1255322194

Specialty Benchmarks & Practice Insights

Comparative analytics for Massage Therapist in Gresham, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.5 Yrs
Regional Practice Density
132 Specialists

Practicing in Gresham, OR (6180 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Massage Therapist Primary Specialty

NUCC Taxonomy Code: 225700000X

State License OR 7615

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Dr. Henry Windell , DMD

Dentist - Oral and Maxillofacial Pathology

NPI 1063413722

Doctor of Dental Medicine

June Hobbs , CNM

Advanced Practice Midwife

NPI 1063558807

Certified Nurse Midwife

Gretchen Grooms , LMT

Massage Therapist

NPI 1124575139

Licensed Massage Therapist

NPI 1164426110

Doctor of Medicine (M.D.)

NPI 1245220771

Doctor of Medicine (M.D.)

NPI 1356331847

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 09, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location November 09, 2016

Registered at 24850 SE STARK ST, SUITE 200, GRESHAM, OR 970308316 (Tel: 5033102622)

📍
Updated Business Mailing Address November 09, 2016

Registered at 24850 SE STARK ST, SUITE 200, GRESHAM, OR 970308316 (Tel: 5033102622)

👤
Provider Name / Credentials Updated November 09, 2016

Recorded as JENNIFER BOOM, LMT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 09, 2016

Massage Therapist (License #7615 in OR)

🟢
Initial NPI Registration & Enumeration March 21, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164547634
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 21, 2007
Last Update: November 09, 2016
Sole Proprietor: No

Mailing Address

24850 Se Stark St, Suite 200

Gresham, OR 970308316

Phone: 5033102622

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.