Active NPI
Margaret Catherine Wickham, LMT
- Massage Therapist
- Corvallis, OR
National Provider Identifier
1295080703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 5073
- Practice address
- 517 SW 2ND St Ste 100
Corvallis, OR 97333-4885 - Phone
- (541) 257-2149
- NPI assigned
- Jul 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 5073 | OR | Primary |
Addresses
Primary practice location
517 SW 2ND St Ste 100
Corvallis, OR 97333-4885
Mailing address
564 Sw3Rd St
Corvallis, OR 97330
Phone (541) 619-9080
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1019463790-1-1 | Other | OK | FARMERS INSURANCE |
| R01543652 | Other | OR | HEALTH NET |
| 108601 | Other | OR | PROVIDENCE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5073 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552608000000",
"number": "1295080703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "564 SW3RD ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "97330",
"telephone_number": "541-619-9080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 SW 2ND ST STE 100",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973334885",
"telephone_number": "541-257-2149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKHAM",
"first_name": "MARGARET",
"middle_name": "CATHERINE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-20",
"last_updated": "2019-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "5073",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FARMERS INSURANCE",
"identifier": "1019463790-1-1",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "R01543652",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDENCE",
"identifier": "108601",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.