NPIMap

Organization Active NPI

Great River LLC

Doing business as Hey Moon Community Wellness

  • Acupuncturist
  • Stevenson, WA
National Provider Identifier
1043067580
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
GREAT RIVER LLC
Doing business as
Hey Moon Community Wellness
Practice address
40 SW Cascade Ave # 40F
Stevenson, WA 98648-6284
Phone
(509) 416-6191
NPI assigned
May 2, 2024
Last updated
Oct 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Katherine Kampmann, L.AC.NPI 1114634029
Title
Owner
Phone
(509) 416-6191

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

40 SW Cascade Ave # 40F
Stevenson, WA 98648-6284

Mailing address

PO Box 1351
Stevenson, WA 98648-1351

Other names 1

  • Hey Moon Community Wellness Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1043067580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1351",
            "city": "STEVENSON",
            "state": "WA",
            "postal_code": "986481351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SW CASCADE AVE # 40F",
            "city": "STEVENSON",
            "state": "WA",
            "postal_code": "986486284",
            "telephone_number": "509-416-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "KAMPMANN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-416-6191",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hey Moon Community Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hey Moon Community Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stevenson, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.