Avalon Massage & Day Spa LTD

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00009684 Issued in WA

Legal business name

AVALON MASSAGE & DAY SPA LTD

Practice address

660 W Evergreen Farm Way
Sequim, WA 98382-5097

Phone

(360) 582-9977

Fax

(360) 582-9972

NPI assigned

Jul 5, 2006

Organization subpart

No

Name

Mrs. Mindy Sue Wiegel, LMP

Title

Owner

Phone

(360) 582-9977

Organizations that report the same tax identification number in the National Provider Directory.

• Avalon Massage & Day Spa

  • Specialist
  • Sequim, WA
  • NPI 1114198199
  NPD tax ID
• Avalon Massage and Day Spa LTD Limited

  • Mechanotherapist
  • Sequim, WA
  • NPI 1396916375
  NPD tax ID

Tax ID family

Avalon Massage and Day Spa LTD Limited (3 organizations share this tax ID)

• Mindy's Massage Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013947787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "CARLSBORG",
            "state": "WA",
            "postal_code": "98324",
            "telephone_number": "360-582-9977",
            "fax_number": "360-582-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 W EVERGREEN FARM WAY",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983825097",
            "telephone_number": "360-582-9977",
            "fax_number": "360-582-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON MASSAGE & DAY SPA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIEGEL",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-582-9977",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00009684",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157675",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMENA BC",
            "identifier": "204592204592",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "W15428",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindy's Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary L Arnott, LMHC
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• Militza Ausmanas, M.D.
• Avalon Massage & Day Spa
• Avalon Massage and Day Spa LTD Limited
• Carla Christina Castillo Avis, PHARMACIST
• Phyllis Leslie Ayer, PT, CST-C, MA
• Amanda Lynn Baietto
• Kelli Baker, RD

• All providers in Sequim, WA
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.