Individual provider Active NPI

Nicole Guerra Willingham, LMT

  • Massage Therapist
  • Bend, OR
National Provider Identifier
1043047095
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27761 Issued in OR
Practice address
929 SW Simpson Ave Ste 150
Bend, OR 97702-3599
Phone
(458) 202-1066
Fax
(866) 728-1099
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 27761 OR Primary

Addresses

Primary practice location

929 SW Simpson Ave Ste 150
Bend, OR 97702-3599

Mailing address

1238 SW Silver Lake Blvd
Bend, OR 97702-2236
Phone (458) 600-3249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27761ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ruegsegger Chiropractic, PC CurrentSince Sep 23, 2024 Accepting new patients
Goulart Family Chiropractic Inc PastSince Sep 23, 2024 Accepting new patients

Locations

424 NE Franklin Ave
Bend, OR 97701
Phone (541) 388-3588

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1043047095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 SW SILVER LAKE BLVD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022236",
            "telephone_number": "458-600-3249",
            "fax_number": "866-728-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 SW SIMPSON AVE STE 150",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023599",
            "telephone_number": "458-202-1066",
            "fax_number": "866-728-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA WILLINGHAM",
        "first_name": "NICOLE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "27761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; 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.