Johnell Vee Hall, LMP
Individual provider Active NPI Massage Therapist · Washougal, WA
NPI 1104182138 · NPPES record last updated Apr 4, 2012
Key facts
- NPI
- 1104182138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA 60263712 (WA)
- Practice address
- 3307 Evergreen Way
Suite 601
Washougal, WA 98671-2062 - Phone
- (360) 835-9911
- Fax
- (360) 835-5765
- NPI assigned
- Apr 4, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 60263712 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael a. Dornbusch, DC, PS | Massage Therapist | Past |
Accepting new patients |
| Pure Wellness Chiropractic Washougal PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA 60263712 | WA | Yes |
Addresses
Primary practice location
3307 Evergreen Way
Suite 601
Washougal, WA 98671-2062
Mailing address
11635 NE Prescott St
Portland, OR 97220-1434
Phone (360) 241-7667
Other providers in Washougal, WA
- Clare Griffis
- Vanessa Raven-Ann Griffith
- Mary Grode
- Joshua Wayne Grooms
- Mark Hadley
- Renae Christine Hamilton Buchholtz
- Rebecca Ann Hamm
- Crimson N Hammer-Ocegueda
- Kim R Hansen
- Harmony Dental
All providers in Washougal, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.