Nicole Renea Anderson, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00023956 Issued in WA

Practice address

100 Ruby Street
Suite F
Tumwater, WA 98501

Phone

(360) 943-4797

Fax

(360) 709-0542

NPI assigned

Jun 19, 2007

Last updated

Jul 29, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Wellness Massage, LLC

  • Massage Therapist
  • Tumwater, WA
  • NPI 1790167971
  Authorized official Same address or phone

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1144425182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RUBY STREET",
            "address_2": "SUITE F",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "98501",
            "telephone_number": "360-943-4797",
            "fax_number": "360-709-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RUBY STREET",
            "address_2": "SUITE F",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "98501",
            "telephone_number": "360-943-4797",
            "fax_number": "360-709-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "NICOLE",
        "middle_name": "RENEA",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammed Alrahbi, DDS
• Rita Altamore, M.D., M.P.H.
• Alexander Anderson
• Matthew Richard Anderson, ARNP
• Molly M Anderson, LMP
• Robbi Doran Anderson, RN BSN
• Robert Anderson, RPH
• Andrew J Kapust DDS PS
• Amy Andrews, LMT
• Maggie Jean Andrus

• Massage Therapist in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.