Active NPI
Traci Anne Warden, LMT
- Massage Therapist
- Springfield, OR
National Provider Identifier
1326698481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 25219
- Practice address
- 870 W Centennial Blvd Ste B
Springfield, OR 97477-2871 - Phone
- (541) 510-5907
- NPI assigned
- Sep 19, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 25219 | OR | Primary |
Addresses
Primary practice location
870 W Centennial Blvd Ste B
Springfield, OR 97477-2871
Mailing address
870 W Centennial Blvd Ste B
Springfield, OR 97477-2871
Phone (541) 510-5907
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 922703001 | Other | OR | TAX ID |
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 |
|---|---|---|---|
| 25219 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1326698481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "870 W CENTENNIAL BLVD STE B",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974772871",
"telephone_number": "541-510-5907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 W CENTENNIAL BLVD STE B",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974772871",
"telephone_number": "541-510-5907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARDEN",
"first_name": "TRACI",
"middle_name": "ANNE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-19",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "25219",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "922703001",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.