Active NPI
Connie Lynn Baker, L. M.P.
- Massage Therapist
- Olympia, WA
National Provider Identifier
1124145990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00013731
- Practice address
- 2716 Pacific Ave SE
Suite D
Olympia, WA 98501-8803 - Phone
- (360) 705-4188
- Fax
- (360) 705-0964
- NPI assigned
- Mar 24, 2007
- Sex
- Female
- 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 | MA00013731 | WA | Primary |
Addresses
Primary practice location
2716 Pacific Ave SE
Suite D
Olympia, WA 98501-8803
Mailing address
2716 Pacific Ave SE
Suite D
Olympia, WA 98501-8803
Phone (360) 705-4188
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 |
|---|---|---|---|
| MA00013731 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124145990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2716 PACIFIC AVE SE",
"address_2": "SUITE D",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985018803",
"telephone_number": "360-705-4188",
"fax_number": "360-705-0964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2716 PACIFIC AVE SE",
"address_2": "SUITE D",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985018803",
"telephone_number": "360-705-4188",
"fax_number": "360-705-0964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "CONNIE",
"middle_name": "LYNN",
"credential": "L. M.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00013731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.