Blooming Moon Wellness Spa Inc.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

69864495 Issued in OR

Legal business name

BLOOMING MOON WELLNESS SPA INC.

Practice address

1920 N Killingsworth St
Portland, OR 97217-4437

Phone

(971) 279-2757

NPI assigned

Oct 30, 2012

Last updated

Oct 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ginny L Tousignant, ESTHETICIAN COS-FT

Title

Owner and Esthetician

Phone

(971) 279-2757

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly Elaine Hale, L.M.T.

  • Massage Therapist
  • Portland, OR
  • NPI 1265786644
  NPD (past)
• Kayla Norwood, LMT

  • Massage Therapist
  • Portland, OR
  • NPI 1457721748
  NPD (past)
• Jeanette Ann Slay, LMT

  • Specialist
  • Portland, OR
  • NPI 1154782993
  NPD (past)

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1144574096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174437",
            "telephone_number": "971-279-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174437",
            "telephone_number": "971-279-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING MOON WELLNESS SPA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "TOUSIGNANT",
        "authorized_official_first_name": "GINNY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER AND ESTHETICIAN",
        "authorized_official_telephone_number": "971-279-2757",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ESTHETICIAN COS-FT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "69864495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Bloom
• Linnaeus Bloom
• Maggie Bloom, PH.D.
• Hannah Lynn Bloombaum
• Catherine Ann Bloome, OTR/L
• Catherine Gail Blosser, PNP
• Blossom Counseling LLC
• Blossom in Unity, LLC (Lucrecia Suarez, LCSW)
• Catherine Blouke, CADC-R
• Devon Blount

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.