Metamorphic Massage & Wellness Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

MA00022554 Issued in WA

Legal business name

METAMORPHIC MASSAGE & WELLNESS INC

Practice address

6342 Littlerock Rd SW
Tumwater, WA 98512-7332

Phone

(360) 520-3011

NPI assigned

Nov 4, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Lynn Herron, LMP, MMP

Title

Owner/Lead Massage Therapist

Phone

(360) 520-3011

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1114390762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6342 LITTLEROCK RD SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127332",
            "telephone_number": "360-520-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6342 LITTLEROCK RD SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127332",
            "telephone_number": "360-520-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHIC MASSAGE & WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "HERRON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/LEAD MASSAGE THERAPIST",
        "authorized_official_telephone_number": "360-520-3011",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMP, MMP"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "MA00022554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Lorraine Mead, LMP
• Meditelecare of Washington PLLC
• Christopher Dalton Merchant, DDS
• Melanie D Merritt, LPN
• Terence P Mertens, OTR/L
• Merri Caitlin Metcalfe, RDN, CSSD
• Metta Counselling and Wellness PLLC
• Ebony L Middleton
• Milestone Therapy PLLC
• Chandra E Miller-Starks, LMHC

• Preferred Provider Organization in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Preferred Provider Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.