Individual provider Active NPI

Mikayla Wood, MA61329598

  • Massage Therapist
  • Ephrata, WA
National Provider Identifier
1194457689
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61329598 Issued in WA
Practice address
1519 Basin St SW
Ephrata, WA 98823-2135
Phone
(509) 754-2461
Fax
(509) 754-2462
NPI assigned
Jun 24, 2022
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 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 MA61329598 WA Primary

Addresses

Primary practice location

1519 Basin St SW
Ephrata, WA 98823-2135

Mailing address

1519 Basin St SW
Ephrata, WA 98823-2135
Phone (509) 754-2461

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL mikaylawood.lmt@gmail.com
CONNECT URL https://devine-chiropractic.com/ Dr. Tashauna Devine PLLC

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

State licenses

LicenseStateTypeSpecialty
MA61329598WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Tashauna Devine PLLC CurrentSince Jun 26, 2022 Accepting new patients
William B Davis Inc PS CurrentSince Jun 26, 2022 Accepting new patients

Locations

1519 Basin St SW
Ephrata, WA 98823
Phone (509) 431-3553

Organizations & group practices 2

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": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1194457689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 BASIN ST SW",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988232135",
            "telephone_number": "509-754-2461",
            "fax_number": "509-754-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 BASIN ST SW",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988232135",
            "telephone_number": "509-754-2461",
            "fax_number": "509-754-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "MIKAYLA",
        "credential": "MA61329598",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61329598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mikaylawood.lmt@gmail.com",
            "affiliation": "N",
            "address_1": "150 E St SW",
            "city": "Ephrata",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988231827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://devine-chiropractic.com/",
            "affiliation": "Y",
            "affiliationName": "Dr. Tashauna Devine PLLC",
            "address_1": "1519 Basin St SW",
            "city": "Ephrata",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988232135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ephrata, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.