Individual provider Active NPI

Brenda Q Mills, LMP

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1366708646
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60250697 Issued in WA
Practice address
1104 Main St
Suite #105
Vancouver, WA 98660
Phone
(360) 931-3867
NPI assigned
Apr 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60250697 WA Primary

Addresses

Primary practice location

1104 Main St
Suite #105
Vancouver, WA 98660

Mailing address

1104 Main St
Suite 105
Vancouver, WA 98660-2999
Phone (360) 931-3867

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
MA60250697WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1366708646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 MAIN ST",
            "address_2": "SUITE 105",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602999",
            "telephone_number": "360-931-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 MAIN ST",
            "address_2": "SUITE #105",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98660",
            "telephone_number": "360-931-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "BRENDA",
        "middle_name": "Q",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60250697",
            "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 Jun 5, 2013; 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.