Ellie Hickle, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

28695 Issued in OR

Practice address

55 NW Wall St Ste 100
Bend, OR 97703-3200

Phone

(541) 389-4321

Fax

(541) 389-4420

NPI assigned

Jan 3, 2025

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

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 and National Provider Directory roles.

• Falling Waters LLC

  • Chiropractor
  • Bend, OR
  • NPI 1154449890
  NPD

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1346059490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NW WALL ST STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033200",
            "telephone_number": "541-389-4321",
            "fax_number": "541-389-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NW WALL ST STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033200",
            "telephone_number": "541-389-4321",
            "fax_number": "541-389-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLE",
        "first_name": "ELLIE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "28695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Wayne Hester, D.M.D.
• Kelli Hewitt
• Sian Jessica Heyworth, APRN-NP
• William Charles Hiatt
• Breyn M Hibbs, CRM
• Laura Lytton Hickmond, N.P.
• Kalah Irene Hickox
• Alicia J Hicks, PA-C
• Austin Hicks
• Dan Hicks, LPC

• Massage Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.