Active NPI
Bronson Holland, LMT
- Massage Therapist
- East Wenatchee, WA
National Provider Identifier
1093327520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 61093415
- Practice address
- 100 Eastmont Ave Ste B2
East Wenatchee, WA 98802-7706 - Phone
- (509) 741-0087
- NPI assigned
- Aug 17, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 61093415 | WA | Primary |
Addresses
Primary practice location
100 Eastmont Ave Ste B2
East Wenatchee, WA 98802-7706
Mailing address
298 Connery Rd
Wenatchee, WA 98801-8906
Phone (509) 741-0087
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
| License | State | Type | Specialty |
|---|---|---|---|
| 61093415 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1093327520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "298 CONNERY RD",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988018906",
"telephone_number": "509-741-0087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EASTMONT AVE STE B2",
"city": "EAST WENATCHEE",
"state": "WA",
"postal_code": "988027706",
"telephone_number": "509-741-0087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "BRONSON",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-17",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "61093415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Wenatchee, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.