Brenda Marie Harris
Individual provider Active NPI Massage Therapist · Washougal, WA
NPI 1801457486 · NPPES record last updated Jun 25, 2019
Key facts
- NPI
- 1801457486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA60960591 (WA)
- Practice address
- 3307 Evergreen Way Ste 601
Washougal, WA 98671-2062 - Phone
- (360) 835-9911
- NPI assigned
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Theology
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60960591 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washougal Family Medicine, PS | Past | Accepting new patients | |
| Pure Wellness Chiropractic Washougal PLLC | Past |
Accepting new patients | |
| Michael a. Dornbusch, DC, PS | Massage Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60960591 | WA | Yes |
Addresses
Primary practice location
3307 Evergreen Way Ste 601
Washougal, WA 98671-2062
Mailing address
18699 NE Marine Dr Slip K5
Portland, OR 97230-7360
Phone (918) 812-2086
Other providers in Washougal, WA
- Renae Christine Hamilton Buchholtz
- Rebecca Ann Hamm
- Crimson N Hammer-Ocegueda
- Kim R Hansen
- Harmony Dental
- Samantha Haugland
- Erin Hayter
- Vicki Lynne Hines
- Megan R Hitchcock
- Siana Rose Hoffman
All providers in Washougal, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 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.