Crystal Lynn Spencer, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAS-3615 Issued in ID

Practice address

9407 N Government Way
Suite 3
Hayden, ID 83835-7414

Phone

(208) 659-2296

NPI assigned

Nov 7, 2019

Sex

Female

Sole proprietor

No

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.

• Balanced Body Massage

  • Massage Therapist
  • Hayden, ID
  • NPI 1821982950
  NPD (past)
• Body Tech Massage & Wellness

  • Primary Care Clinic/Center
  • Hayden, ID
  • NPI 1073120317
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 8, 2023.

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1164067609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 N. GOVERNMENT WAY",
            "address_2": "SUITE 3",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357414",
            "telephone_number": "208-659-2296",
            "fax_number": "208-659-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9407 N GOVERNMENT WAY",
            "address_2": "SUITE 3",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357414",
            "telephone_number": "208-659-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS-3615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPY",
            "identifier": "455329257",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Troy David Soenen
• Sonny Physical Therapy, LLC
• Robert A Sorensen, O.D.
• Spark Med Spa, LLC
• Spear TMS
• Amy Lynn Spoelstra, D.C.
• State of Idaho
• Valerie Steinhoff
• Laura Handyside Steininger, DPT
• Brian S Stewart, PHARMD

• All providers in Hayden, ID
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.