Individual provider Active NPI

Bryan Oliver

  • Massage Therapist
  • Lynnwood, WA
National Provider Identifier
1114102100
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00024469 Issued in WA
Practice address
15503 18TH Ave W Apt 1a
Lynnwood, WA 98087-6082
Phone
(425) 765-1572
NPI assigned
Jan 8, 2008
Last updated
Mar 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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 MA00024469 WA Primary

Addresses

Primary practice location

15503 18TH Ave W Apt 1a
Lynnwood, WA 98087-6082

Mailing address

14405 NE 20TH St # 1
Bellevue, WA 98007-3710
Phone (425) 641-2527

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
MA00024469WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montaland McGrath Chiropractic Center, PS, Inc PastSince Mar 28, 2005 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237507200000",
    "number": "1114102100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14405 NE 20TH ST # 1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073710",
            "telephone_number": "425-641-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15503 18TH AVE W APT 1A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980876082",
            "telephone_number": "425-765-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "BRYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-08",
        "last_updated": "2009-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; 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.