Brenda D Page, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00018640 Issued in WA

Practice address

205 Bethel Ave
Port Orchard, WA 98366-5215

Phone

(360) 440-2590

Fax

(360) 874-1739

NPI assigned

Mar 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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 and National Provider Directory roles.

• Bodiwerks 1, Inc

  • Massage Therapist
  • Port Orchard, WA
  • NPI 1902079668
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285767871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 GOLDFINCH ST",
            "address_2": "APT C",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982774783",
            "telephone_number": "360-720-2595",
            "fax_number": "360-874-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BETHEL AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665215",
            "telephone_number": "360-440-2590",
            "fax_number": "360-874-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "BRENDA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00018640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE #",
            "identifier": "MA00018640",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FULL CIRCLE ID",
            "identifier": "4146S5-00",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa R Ottenbacher, ARNP
• Andrew Michael Owen, D.O.
• Ariana Sage Ozog
• Pacific Physical Therapy PLLC
• Nicole Marie Padmos, DPT
• Tamera F Page, LMP
• Young-Ki Paik, M.D.
• Chinsu Pak, PHARM D.
• Demery Paladichuk, ARNP
• Brett Douglas Palmer, PT

• Specialist in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.