NPIMap

Organization Active NPI

Under the Influence of Massage

  • Preferred Provider Organization
  • Vancouver, WA
National Provider Identifier
1134492986
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
MA00016071 Issued in WA
Legal business name
UNDER THE INFLUENCE OF MASSAGE
Practice address
1612 NE 78TH St
Vancouver, WA 98665-9635
Phone
(360) 573-3223
NPI assigned
Feb 9, 2012
Organization subpart
Yes
Parent organization
UNDER THE INFLUENCE OF MASSAGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Authorized official

Name
Alicia Jacoby, LMPNPI 1508814187
Title
Owner
Phone
(360) 573-3223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X MA00016071 WA Primary

Addresses

Primary practice location

1612 NE 78TH St
Vancouver, WA 98665-9635

Mailing address

1612 NE 78TH St
Vancouver, WA 98665-9635
Phone (360) 573-3223

National Provider Directory

National Provider Directory
Part of
Under the Influence of Massage

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1134492986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 NE 78TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986659635",
            "telephone_number": "360-573-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 NE 78TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986659635",
            "telephone_number": "360-573-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNDER THE INFLUENCE OF MASSAGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNDER THE INFLUENCE OF MASSAGE",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "JACOBY",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-573-3223",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "MA00016071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.