Individual provider Active NPI

Kristina Oliver, LMT

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1336463389
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60555361 Issued in WA
Practice address
311 W Evergreen Blvd
Ste. #100
Vancouver, WA 98660-3371
Phone
(360) 907-3648
NPI assigned
Mar 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 15838 OR
Doula 374J00000X
Massage Therapist 225700000X MA60555361 WA Primary

Addresses

Primary practice location

311 W Evergreen Blvd
Ste. #100
Vancouver, WA 98660-3371

Mailing address

14505 NE 20TH Ave Apt 61
Vancouver, WA 98686-1490
Phone (360) 907-3648

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

LicenseStateTypeSpecialty
15838ORMDMassage Therapist
MA60555361WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartful Healing, LLC Massage Therapist Past 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": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1336463389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14505 NE 20TH AVE APT 61",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861490",
            "telephone_number": "360-907-3648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W EVERGREEN BLVD",
            "address_2": "STE. #100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603371",
            "telephone_number": "360-907-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "KRISTINA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "15838",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60555361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.