Active NPI
Candice M Isom, LMP
- Massage Therapist
- Liberty Lake, WA
National Provider Identifier
1497991343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00019234
- Practice address
- 23410 E Mission Ave
Liberty Lake, WA 99019-7515 - Phone
- (509) 999-4780
- Fax
- (509) 924-8242
- NPI assigned
- Dec 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | MA00019234 | WA | Primary |
Addresses
Primary practice location
23410 E Mission Ave
Liberty Lake, WA 99019-7515
Mailing address
23410 E Mission Ave
Liberty Lake, WA 99019-7515
Phone (509) 999-4780
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 |
|---|---|---|---|
| MA00019234 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230076800000",
"number": "1497991343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23410 E MISSION AVE",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990197515",
"telephone_number": "509-999-4780",
"fax_number": "509-924-8242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23410 E MISSION AVE",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990197515",
"telephone_number": "509-999-4780",
"fax_number": "509-924-8242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISOM",
"first_name": "CANDICE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-24",
"last_updated": "2008-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00019234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty Lake, WA
- Integrated Health and Behavior, PLLC
- Intelligent Balance Chiropractic Spinal Care, PLLC
- Intelligent Balance Chiropractic Spinal Care, PLLC
- Intelligent Balance Spinal Care, PLLC
- Introspective Health PLLC
- J. Evans, DMD, P.S.
- Adam Jaccard, PHARMD
- Staci Wixom Jacobs, LMP
- Benjamin Wells Jaderholm, D.O.
- Jan Nelson NP-C, Dba, Balanced Wellness Medical Clinic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.