Brenda Phin Keller, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60599174 Issued in WA

Practice address

301 Croft Ave
Gold Bar, WA 98251-9619

Phone

(360) 793-0904

NPI assigned

Oct 10, 2022

Last updated

Oct 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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.

• Gold Bar Chiropractic P.L.L.C

  • Chiropractor
  • Monroe, WA
  • NPI 1538170097

  Massage Therapist

  NPD

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1184349300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CROFT AVE",
            "city": "GOLD BAR",
            "state": "WA",
            "postal_code": "982519619",
            "telephone_number": "360-799-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CROFT AVE",
            "city": "GOLD BAR",
            "state": "WA",
            "postal_code": "982519619",
            "telephone_number": "360-793-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "BRENDA",
        "middle_name": "PHIN",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60599174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Gold Bar, WA
• Providers in Gold Bar, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.