Hollyanne Samuelsen, MA, BCTMB

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60002568 Issued in WA

Practice address

709 Griffin Ave
Enumclaw, WA 98022-3419

Phone

(253) 350-3833

NPI assigned

Apr 27, 2021

Last updated

Apr 27, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Megan's Massage and Esthetics LLC

  dba Megan's Massage

  • Massage Therapist
  • Enumclaw, WA
  • NPI 1558993725
  NPD

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1336721539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 GRIFFIN AVE # 914",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223418",
            "telephone_number": "206-915-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 GRIFFIN AVE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223419",
            "telephone_number": "253-350-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSEN",
        "first_name": "HOLLYANNE",
        "credential": "MA, BCTMB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60002568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Enumclaw, WA
• Providers in Enumclaw, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.