Individual provider Active NPI

Lisa Lorraine Gross, L.M.P.

  • Massage Therapist
  • Silverdale, WA
National Provider Identifier
1659634392
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 60264809 Issued in WA
Practice address
3595 NW Bucklin Hill Rd
Silverdale, WA 98383-8503
Phone
(360) 698-3140
Fax
(360) 698-1441
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 MA 60264809 WA Primary

Addresses

Primary practice location

3595 NW Bucklin Hill Rd
Silverdale, WA 98383-8503

Mailing address

PO Box 483
Silverdale, WA 98383-0483
Phone (360) 698-3140

Other names 1

  • Lisa Lorraine Waldbillig Former name

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
MA 60264809WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Medical Supply, LLC CurrentSince May 17, 2020 Accepting new patients
The Chiropractors Clinic, P.S. PastSince Dec 7, 2017 Accepting new patients

Locations

3595 NW Bucklin Hill Rd
Silverdale, WA 98383
Phone (360) 698-3140

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659634392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 483",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983830483",
            "telephone_number": "360-698-3140",
            "fax_number": "360-698-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 NW BUCKLIN HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838503",
            "telephone_number": "360-698-3140",
            "fax_number": "360-698-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "LISA",
        "middle_name": "LORRAINE",
        "credential": "L.M.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60264809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WALDBILLIG",
            "middle_name": "LORRAINE",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.