Angela Alice Chapin, MT
Individual provider Active NPI Massage Therapist · Ponderay, ID
NPI 1679110845 · NPPES record last updated Dec 5, 2019
Key facts
- NPI
- 1679110845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MAS3548 (ID)
- Practice address
- 30544 Highway 200
Ponderay, ID 83852-5005 - Phone
- (208) 255-9559
- NPI assigned
- Dec 5, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MAS3548 | ID | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAS3548 | ID | Yes |
Addresses
Primary practice location
30544 Highway 200
Ponderay, ID 83852-5005
Mailing address
43 Sandy Beach LN
Cocolalla, ID 83813-8705
Phone (208) 659-2603
Other names
- Angela Alice Chapin
Other providers in Ponderay, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.