Individual provider Active NPI

Christie R Wride, LMP

  • Massage Therapist
  • Burien, WA
National Provider Identifier
1295019180
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60247245 Issued in WA
Practice address
12260 4TH Ave SW
Burien, WA 98146-2951
Phone
(206) 890-4292
NPI assigned
Oct 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60247245 WA Primary

Addresses

Primary practice location

12260 4TH Ave SW
Burien, WA 98146-2951

Mailing address

12260 4TH Ave SW
Burien, WA 98146-2951
Phone (206) 890-4292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Theology

State licenses

LicenseStateTypeSpecialty
MA60247245WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Clinic of Chiropractic PastSince Mar 1, 2008 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1295019180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12260 4TH AVE SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981462951",
            "telephone_number": "206-890-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12260 4TH AVE SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981462951",
            "telephone_number": "206-890-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIDE",
        "first_name": "CHRISTIE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60247245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.