Individual provider Active NPI

Kristen L Bauer, LMP

  • Massage Therapist
  • Longview, WA
National Provider Identifier
1083028658
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60373991 Issued in WA
Practice address
820 Ocean Beach Hwy Ste 120
Longview, WA 98632-4081
Phone
(360) 414-3220
Fax
(360) 353-5350
NPI assigned
Jun 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 MA60373991 WA Primary

Addresses

Primary practice location

820 Ocean Beach Hwy Ste 120
Longview, WA 98632-4081

Mailing address

14313 NE 20TH Ave
Suite A112
Vancouver, WA 98686-1487
Phone (360) 574-9440

Other practice location 1

14313 NE 20th Ave
A112
Vancouver, WA 98686-1487
Phone (360) 574-9440

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
MA60373991WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Choice Chiropractic LLC PastSince Mar 4, 2019 Accepting new patients
Riverwoods Chiropractic & Massage, PLLC PastSince Mar 1, 2013 Accepting new patients

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": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1083028658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14313 NE 20TH AVE",
            "address_2": "SUITE A112",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861487",
            "telephone_number": "360-574-9440",
            "fax_number": "360-574-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 OCEAN BEACH HWY STE 120",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324081",
            "telephone_number": "360-414-3220",
            "fax_number": "360-353-5350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14313 NE 20th Ave",
            "address_2": "A112",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986861487",
            "country_code": "US",
            "telephone_number": "360-574-9440",
            "fax_number": "360-574-9288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUER",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60373991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

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