NPIMap

Organization Active NPI

Fern & Fae Massage

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1255038295
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
FERN & FAE MASSAGE
Practice address
100 E 19TH St Ste 500
Vancouver, WA 98663-3385
Phone
(360) 313-6465
NPI assigned
Feb 9, 2023
Last updated
Feb 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Laurel M Clark, LMTNPI 1114455979
Title
Co-Owner/LMT
Phone
(360) 313-6465

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X NU Primary

Addresses

Primary practice location

100 E 19TH St Ste 500
Vancouver, WA 98663-3385

Mailing address

100 E 19TH St Ste 500
Vancouver, WA 98663-3385
Phone (360) 313-6465

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1255038295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 19TH ST STE 500",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633385",
            "telephone_number": "360-313-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 19TH ST STE 500",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633385",
            "telephone_number": "360-313-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERN & FAE MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LAUREL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-OWNER/LMT",
        "authorized_official_telephone_number": "360-313-6465",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.