Eravanh Boutsomsi, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

931555 Issued in AK

Practice address

7731 E Northern Lights Blvd
Suite 220
Anchorage, AK 99504-3554

Phone

(907) 727-2720

Fax

(907) 332-1490

NPI assigned

Jul 7, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246924800000",
    "number": "1023247491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210856",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995210856",
            "telephone_number": "907-727-2720",
            "fax_number": "907-332-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7731 E NORTHERN LIGHTS BLVD",
            "address_2": "SUITE 220",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043554",
            "telephone_number": "907-727-2720",
            "fax_number": "907-332-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTSOMSI",
        "first_name": "ERAVANH",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "931555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Bourne
• Bourne's Care Coordination LLC
• Jamie Marie Bourque, NP
• Caroline Bourquin
• Boutsomsi Care
• Sienh Cindy Boutsomsi, RN
• Maram M Boutwell, APRN
• Theresa Bovey
• Elizabeth Jean Bow, O.D.
• Miranda Nicole Bowen

• Massage Therapist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.