Individual provider Active NPI

Cristina Tiscareno-Villa, MASSAGE THERAPIST

  • Massage Therapist
  • Walla Walla, WA
National Provider Identifier
1740617893
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60354201 Issued in WA
Practice address
1618 Isaacs Street
Walla Walla, WA 99362
Phone
(509) 301-7922
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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 MA60354201 WA Primary

Addresses

Primary practice location

1618 Isaacs Street
Walla Walla, WA 99362

Mailing address

721 SE 4TH St Apt E
College Place, WA 99324-2301
Phone (509) 301-7922

Other practice location 1

1020 N Center Pkwy
Suit E
Kennewick, WA 99336-7161
Phone (509) 735-1109

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
MA60354201WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Briggs Chiropractic, P.S. 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.

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1740617893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 SE 4TH ST APT E",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993242301",
            "telephone_number": "509-301-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 ISAACS STREET",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-301-7922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 N Center Pkwy",
            "address_2": "Suit E",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993367161",
            "country_code": "US",
            "telephone_number": "509-735-1109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TISCARENO-VILLA",
        "first_name": "CRISTINA",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60354201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.