Individual provider Active NPI

Cynthia L Gillick, L.M.P.

  • Massage Therapist
  • Bremerton, WA
National Provider Identifier
1497974992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00019965 Issued in WA
Practice address
6611 Kitsap Way
Bremerton, WA 98312-1741
Phone
(360) 377-8770
Fax
(206) 666-3739
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00019965 WA Primary

Addresses

Primary practice location

6611 Kitsap Way
Bremerton, WA 98312-1741

Mailing address

9341 Nika TRL NW
Silverdale, WA 98383-9304
Phone (360) 649-8426

Other identifiers 2

IdentifierTypeStateIssuer
0201438OtherWADEPT OF LABOR & INDUSTRIE
8925559OtherWACRIME VICTIMS COMP PROGRA

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
MA00019965WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497974992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9341 NIKA TRL NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839304",
            "telephone_number": "360-649-8426",
            "fax_number": "206-666-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 KITSAP WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121741",
            "telephone_number": "360-377-8770",
            "fax_number": "206-666-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLICK",
        "first_name": "CYNTHIA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00019965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRIE",
            "identifier": "0201438",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS COMP PROGRA",
            "identifier": "8925559",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.