Active NPI
Samara R Thelen, MA
- Massage Therapist
- Enumclaw, WA
National Provider Identifier
1154086593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00022106
- Practice address
- 709 Griffin Ave
Enumclaw, WA 98022-3419 - Phone
- (253) 350-3833
- NPI assigned
- Nov 1, 2021
- Last updated
- Nov 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00022106 | WA | Primary |
Addresses
Primary practice location
709 Griffin Ave
Enumclaw, WA 98022-3419
Mailing address
219 Jewell St
Enumclaw, WA 98022-7329
Phone (253) 350-3833
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00022106 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Megan's Massage and Esthetics LLC | Massage Therapist | Current | Accepting new patients |
Locations
709 Griffin Ave
Enumclaw, WA 98022
Phone (253) 350-3833
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635724800000",
"number": "1154086593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 JEWELL ST",
"city": "ENUMCLAW",
"state": "WA",
"postal_code": "980227329",
"telephone_number": "253-350-3833",
"fax_number": "253-350-3833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 GRIFFIN AVE",
"city": "ENUMCLAW",
"state": "WA",
"postal_code": "980223419",
"telephone_number": "253-350-3833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THELEN",
"first_name": "SAMARA",
"middle_name": "R",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-01",
"last_updated": "2021-11-01",
"certification_date": "2021-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00022106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Enumclaw, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.