NPIMap

Organization Active NPI

Fitness Recovery Room LLC

  • Clinic/Center
  • Lacey, WA
National Provider Identifier
1013453554
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
603440613 Issued in WA
Legal business name
FITNESS RECOVERY ROOM LLC
Practice address
8830 Tallon LN NE
F
Lacey, WA 98516-6656
Phone
(360) 819-2877
NPI assigned
Jan 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jamil Ellinger, LMPNPI 1386000115
Title
Owner/Registered Agent
Phone
(360) 951-4893

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 603440613 WA Primary

Addresses

Primary practice location

8830 Tallon LN NE
F
Lacey, WA 98516-6656

Mailing address

8830 Tallon LN NE
F
Lacey, WA 98516-6656
Phone (360) 819-2877

Other names 1

  • Hawks Prairie Massage Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

8830 Tallon Ln NE
Ste F
Lacey, WA 98516
Phone (360) 819-2877

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1013453554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8830 TALLON LN NE",
            "address_2": "F",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985166656",
            "telephone_number": "360-819-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8830 TALLON LN NE",
            "address_2": "F",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985166656",
            "telephone_number": "360-819-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITNESS RECOVERY ROOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "ELLINGER",
        "authorized_official_first_name": "JAMIL",
        "authorized_official_title_or_position": "OWNER/REGISTERED AGENT",
        "authorized_official_telephone_number": "360-951-4893",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "603440613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawks Prairie Massage Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.