Changing Tides LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00002068 Issued in WA

Legal business name

CHANGING TIDES LLC

Practice address

21222 Viking Ave NW
Poulsbo, WA 98370

Phone

(360) 731-9717

NPI assigned

Jul 27, 2007

Organization subpart

No

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

Authorized official

Name

Miss Claire Ann Brown, LICENSED MASSAGE PRA

Title

LMP Manager

Phone

(360) 731-9717

Specialties & licenses 1

Addresses

Other names 1

• Claire Brown LMP Former legal business name

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1902096712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13250 PHELPS ROAD NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981104141",
            "telephone_number": "360-731-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21222 VIKING AVE NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "360-731-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIDES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CLAIRE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LMP MANAGER",
        "authorized_official_telephone_number": "360-731-9717",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LICENSED MASSAGE PRA"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00002068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Claire Brown LMP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Massage Therapist in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.