NPIMap

Organization Active NPI

NW Massage Therapy Corp

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1255852117
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00011374
Legal business name
NW MASSAGE THERAPY CORP
Practice address
16906 SE 1St St Ste 103
Vancouver, WA 98684-8512
Phone
(360) 903-9963
NPI assigned
Jun 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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

Authorized official

Name
Douglas Black, LMPNPI 1295855138
Title
President
Phone
(360) 903-9963

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X MA00011374 Primary

Addresses

Primary practice location

16906 SE 1St St Ste 103
Vancouver, WA 98684-8512

Mailing address

17413 NE 3Rd St
Vancouver, WA 98684-3730
Phone (360) 903-9963

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498780800000",
    "number": "1255852117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17413 NE 3RD ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986843730",
            "telephone_number": "360-903-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16906 SE 1ST ST STE 103",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986848512",
            "telephone_number": "360-903-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW MASSAGE THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-903-9963",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": "MA00011374",
            "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 Jun 30, 2017; 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.