Andrea M. Ellestad, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

1098 Issued in MT

Legal business name

ANDREA M. ELLESTAD, LLC

Practice address

3700 S Russell St Suite 106
Missoula, MT 59801

Phone

(406) 203-6207

NPI assigned

Dec 12, 2011

Organization subpart

No

Name

Andrea M. Ellestad, LMT

Title

Manager

Phone

(406) 203-6207

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 16, 2025.

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1124396601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10236 PALE MORNING CT",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59808",
            "telephone_number": "406-203-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 S RUSSELL ST SUITE 106",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59801",
            "telephone_number": "406-203-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA M. ELLESTAD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "ELLESTAD",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "406-203-6207",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "MT",
            "license": "1098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Missoula, MT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.