Active NPI
Andrea Mischelle Macy, LMT
- Massage Therapist
- Vancouver, WA
National Provider Identifier
1467221945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA61478829
- Practice address
- 16315 NE 23Rd St
Vancouver, WA 98684-8665 - Phone
- (360) 882-0767
- NPI assigned
- Dec 26, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA61478829 | WA | Primary |
Addresses
Primary practice location
16315 NE 23Rd St
Vancouver, WA 98684-8665
Mailing address
2619 NE 116TH PL
Vancouver, WA 98684-5000
Phone (360) 694-9520
Other practice location 1
1319 NE 134th St Ste 103
Vancouver, WA 98685-2718
Phone (360) 574-3141
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA61478829 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cke Longevity 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": "1703548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703548800000",
"number": "1467221945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2619 NE 116TH PL",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986845000",
"telephone_number": "360-694-9520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16315 NE 23RD ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986848665",
"telephone_number": "360-882-0767"
}
],
"practiceLocations": [
{
"address_1": "1319 NE 134th St Ste 103",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986852718",
"country_code": "US",
"telephone_number": "360-574-3141",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACY",
"first_name": "ANDREA",
"middle_name": "MISCHELLE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-26",
"last_updated": "2023-12-26",
"certification_date": "2023-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA61478829",
"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 Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.