Individual provider Active NPI

Travis Thieszen, MA, LMT

  • Massage Therapist
  • Bellingham, WA
National Provider Identifier
1154073344
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61251937 Issued in WA
Practice address
1155 N State St Ste 305
Bellingham, WA 98225-5024
Phone
(206) 251-8975
NPI assigned
Jan 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA61251937 WA Primary

Addresses

Primary practice location

1155 N State St Ste 305
Bellingham, WA 98225-5024

Mailing address

2101 Cornwall Ave Ste 102
Bellingham, WA 98225-3676
Phone (206) 251-8975

Other practice location 1

2101 Cornwall Ave Ste 102
Bellingham, WA 98225-3676
Phone (360) 671-5706

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MA61251937WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert E Curtis DC PS PastSince Jan 26, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1154073344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CORNWALL AVE STE 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982253676",
            "telephone_number": "206-251-8975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N STATE ST STE 305",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255024",
            "telephone_number": "206-251-8975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Cornwall Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982253676",
            "country_code": "US",
            "telephone_number": "360-671-5706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIESZEN",
        "first_name": "TRAVIS",
        "credential": "MA, LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61251937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.