State of Wellness

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA 60239257 Issued in WA

Legal business name

STATE OF WELLNESS

Practice address

401 W 13TH St
Vancouver, WA 98660-2806

Phone

(319) 325-5579

NPI assigned

Apr 6, 2015

Organization subpart

Yes

Parent organization

ROBERT LACOSSE LLCAs reported in NPPES

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

Authorized official

Name

Kelly Whittingham

Title

Office Manager

Phone

(971) 806-9595

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478908800000",
    "number": "1265827240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W 13TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W 13TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602806",
            "telephone_number": "319-325-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROBERT LACOSSE LLC",
        "enumeration_date": "2015-04-06",
        "last_updated": "2016-11-12",
        "status": "A",
        "authorized_official_last_name": "WHITTINGHAM",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "971-806-9595"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60239257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austen L Stasiak, MD
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• Madison Stassens, LMP,CR
• Olena Stasyuk
• State of Wash - State School for the Blind
• Trevor Staten, FNP-C
• Jaycie Staub
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• Garek Stavens, LMT
• Hellen Stay, RD, CD

• Massage Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2016; 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.