NPIMap

Organization Active NPI

Southcreek Therapeutic Massage, Inc.

  • Massage Therapist
  • Graham, WA
National Provider Identifier
1396952289
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
SOUTHCREEK THERAPEUTIC MASSAGE, INC.
Practice address
22705 Meridian Ave E
Graham, WA 98338-7081
Phone
(253) 875-6400
NPI assigned
May 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Elizabeth Windsor
Title
Operations Project Manager
Phone
(253) 875-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X NU Primary

Addresses

Primary practice location

22705 Meridian Ave E
Graham, WA 98338-7081

Mailing address

22705 Meridian Ave E
Graham, WA 98338-7081

National Provider Directory

National Provider Directory

Locations

22705 Meridian E
Graham, WA 98338
Phone (253) 875-6400

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396952289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22705 MERIDIAN AVE E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983387081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22705 MERIDIAN AVE E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983387081",
            "telephone_number": "253-875-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCREEK THERAPEUTIC MASSAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINDSOR",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OPERATIONS PROJECT  MANAGER",
        "authorized_official_telephone_number": "253-875-6400"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Graham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.