Individual provider Active NPI

Samantha Myer, LMT

  • Registered Dietitian
  • Chehalis, WA
National Provider Identifier
1801308879
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86329307 Issued in WA
Practice address
34 NE Boistfort St Ste 105
Chehalis, WA 98532-2600
Phone
(360) 559-1260
NPI assigned
Oct 31, 2017
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86329307 WA Primary
Massage Therapist 225700000X MA60791815 WA

Addresses

Primary practice location

34 NE Boistfort St Ste 105
Chehalis, WA 98532-2600

Mailing address

642 NW Folsom St
Chehalis, WA 98532-1702
Phone (360) 520-1649

Other practice location 1

2530 NE Kresky Ave Ste B
Chehalis, WA 98532-2406
Phone (360) 529-0319

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
MA60791815WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wholesome Corps LLC Massage Therapist Current Accepting new patients
Peak Sports & Spine Physical Therapy-Renton, P.S. PastSince Sep 14, 2015 Accepting new patients
Medical Massage Inc Massage Therapist Past Accepting new patients

Locations

34 NE Boistfort St
Ste 105
Chehalis, WA 98532
Phone (360) 559-1260

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1801308879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 NW FOLSOM ST",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985321702",
            "telephone_number": "360-520-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 NE BOISTFORT ST STE 105",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322600",
            "telephone_number": "360-559-1260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2530 NE Kresky Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Chehalis",
            "state": "WA",
            "postal_code": "985322406",
            "country_code": "US",
            "telephone_number": "360-529-0319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYER",
        "first_name": "SAMANTHA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "86329307",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60791815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; 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.