Nancy Kristine Haller, GCFP NCMMT LMP MA

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00008877 Issued in WA

Practice address

821 S 219TH St Apt 8
Des Moines, WA 98198-6364

Phone

(425) 282-0406

Fax

(206) 824-7378

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 15

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Theology

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.

• Lifetime Connections Inc. Dba Advanced Wellness Connections

  • Specialist
  • Renton, WA
  • NPI 1154449015
  NPD Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1649358573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 S 219TH ST APT 8",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986364",
            "telephone_number": "425-282-0406",
            "fax_number": "206-824-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 S 219TH ST APT 8",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986364",
            "telephone_number": "425-282-0406",
            "fax_number": "206-824-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "NANCY",
        "middle_name": "KRISTINE",
        "credential": "GCFP NCMMT LMP MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-03-31",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "OR",
            "license": "GCFP1653",
            "primary": false
        },
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "OR",
            "license": "1653",
            "primary": false
        },
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "WA",
            "license": "MA00008877",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "NCMMT0019",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00008877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0151472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMA",
            "identifier": "912120516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICCARE",
            "identifier": "146525495",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH COOPERATIVE",
            "identifier": "533829001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN WHOLEHEALTH NETW",
            "identifier": "912120516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "341120341120",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIFEWISE",
            "identifier": "341120341120",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "912120516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS",
            "identifier": "912120516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GUARDIAN",
            "identifier": "912120516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE",
            "identifier": "912120516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005102596",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "912120516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFORM",
            "identifier": "91212051600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "HA4253",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Dentistry
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• Angelique Ha, RDH
• Kelly Haddenham
• Joshua Hagen
• Hamaika Therapy LLC
• Osman Hamid, MD
• Sandra Rae Harris, L.M.P.
• Kowsar Hassan
• Healing Hands LLC

• Massage Therapist in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.