Nina Bockholdt

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00024738 Issued in WA

Practice address

19319 7TH Ave NE
#100
Poulsbo, WA 98370-7442

Phone

(360) 598-3764

Fax

(360) 598-3282

NPI assigned

Oct 3, 2007

Last updated

Oct 3, 2007By 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

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.

• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Physical Therapist
  • Silverdale, WA
  • NPI 1912902347
  NPD (past)

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1255528253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 CHERRY AVE STE 203",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19319 7TH AVE NE",
            "address_2": "#100",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707442",
            "telephone_number": "360-598-3764",
            "fax_number": "360-598-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKHOLDT",
        "first_name": "NINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sippara Metiku Birri
• Diane Marie Bishop, LMT
• Elizabeth Randell Blackburn, LMFT
• Dale Bliss, RPH
• Kristin Switz Bloink, PA-C, MPH
• Kyle M Bogusz, DO
• David Ryan Bolthouse, M.D.
• Vilma Boon, LMHC
• Erica Aragon Bottai, PA-C
• Boudreaux Optics, P.L.L.C

• Massage Therapist in Poulsbo, WA
• Providers in Poulsbo, 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 3, 2007; 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.