Individual provider Active NPI

Christina Leah Gagelmann, LMT

  • Massage Therapist
  • Camas, WA
National Provider Identifier
1538545249
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60688942 Issued in WA
Practice address
417 NE Birch St
Camas, WA 98607-2139
Phone
(484) 674-5812
NPI assigned
Aug 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 21426 OR
Massage Therapist 225700000X MA60688942 WA Primary

Addresses

Primary practice location

417 NE Birch St
Camas, WA 98607-2139

Mailing address

1206 SE 385TH Ave
Washougal, WA 98671-8775
Phone (484) 674-5812

Other practice location 1

4927 NE 30th Ave
Portland, OR 97211-7007
Phone (503) 281-0681

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
21426ORMDMassage Therapist
MA60688942WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Reynolds Past Accepting new patients
Amy Oldendorf Massage Therapist Past Accepting new patients

Organizations & group practices 2

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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1538545249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 SE 385TH AVE",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986718775",
            "telephone_number": "484-674-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 NE BIRCH ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072139",
            "telephone_number": "484-674-5812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4927 NE 30th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972117007",
            "country_code": "US",
            "telephone_number": "503-281-0681",
            "fax_number": "503-335-6258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGELMANN",
        "first_name": "CHRISTINA",
        "middle_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "21426",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60688942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.