Active NPI
Linda Marie Van Puymbrouck
- Massage Therapist
- Centralia, WA
National Provider Identifier
1669722435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60164609
- Practice address
- 1000 Kresky Ave
Suite O
Centralia, WA 98531-3700 - Phone
- (360) 304-0576
- NPI assigned
- Sep 19, 2012
- 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 | MA 60164609 | WA | Primary |
Addresses
Primary practice location
1000 Kresky Ave
Suite O
Centralia, WA 98531-3700
Mailing address
1000 Kresky Plasa
Suite O
Centralia, WA 98531
Phone (360) 304-0576
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 |
|---|---|---|---|
| MA 60164609 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Massage Inc | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Massage Therapist
- Centralia, WA
- NPI 1902115371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384387200000",
"number": "1669722435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 KRESKY PLASA",
"address_2": "SUITE O",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "98531",
"telephone_number": "360-304-0576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 KRESKY AVE",
"address_2": "SUITE O",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985313700",
"telephone_number": "360-304-0576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN PUYMBROUCK",
"first_name": "LINDA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-19",
"last_updated": "2013-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60164609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.