Ingrid E. Mortensen, L.M.P.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00017106 Issued in WA

Practice address

716 E Edison Ave
Sunnyside, WA 98944-2204

Phone

(509) 837-4455

Fax

(509) 837-6299

NPI assigned

Jan 22, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Complete Therapy Services, PLLC

  • Physical Therapist
  • Sunnyside, WA
  • NPI 1225175474

  Massage Therapist

  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043364821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 E EDISON AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442204",
            "telephone_number": "509-837-4455",
            "fax_number": "509-837-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E EDISON AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442204",
            "telephone_number": "509-837-4455",
            "fax_number": "509-837-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "INGRID",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00017106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0187958",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danna M Micech, FNP
• Mid-Valley Community Clinic, PLLC
• Maria Montelongo
• Patrick James Moran, DO
• Marissa L. Morfin, L.M.P.
• Richard J Mynatt, MD
• N.S. Khurana,DMD, VI, PLLC (Smile Now Orthodontics)
• Nassar Pharm, LLC (Sunnyside Pharmacy)
• Samer Nassar
• Udi Nassar, PHARMD

• Massage Therapist in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.