Shona M Bertholf

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61025052 Issued in WA

Practice address

12121 E Broadway Ave Ste 5B
Spokane Valley, WA 99206-4972

Phone

(509) 954-7354

Fax

(509) 921-9810

NPI assigned

Feb 15, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Valley Massge Clinic

  • Specialist
  • Spokane Valley, WA
  • NPI 1003935875
  NPD (past)

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581724800000",
    "number": "1619500915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 E BROADWAY AVE STE 5B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064972",
            "telephone_number": "509-954-7354",
            "fax_number": "509-921-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 E BROADWAY AVE STE 5B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064972",
            "telephone_number": "509-954-7354",
            "fax_number": "509-921-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTHOLF",
        "first_name": "SHONA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-15",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61025052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan James Bergstrom, LMFT
• Tristina Krakenberg Bermingham
• JB McGregor Bermudez-Koch, DMD DE61197009
• Erin Berry
• Kirsten Sunshine Berry
• Suzanne Bertholic-Liljenberg, LMHCA
• Tammy Lee Bertsch, CDPT
• Chad William Bess, D.C.
• Mark E Bestick, PT, CHT
• Kevin R Bichler, PA-C

• Massage Therapist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.