NPIMap

Organization Active NPI

Medical Massage Inc

  • Massage Therapist
  • Centralia, WA
National Provider Identifier
1902115371
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00013686 Issued in WA
Legal business name
MEDICAL MASSAGE INC
Practice address
1800 Cooks Hill Rd
Suite a
Centralia, WA 98531-9072
Phone
(360) 736-2853
Fax
(360) 736-4159
NPI assigned
Oct 1, 2010
Last updated
Oct 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Authorized official

Name
Mrs. Kimberly Michelle Wilson, LMPNPI 1932269313
Title
Owner/LMP
Phone
(360) 736-2853

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA00013686 WA Primary

Addresses

Primary practice location

1800 Cooks Hill Rd
Suite a
Centralia, WA 98531-9072

Mailing address

1800 Cooks Hill Rd
Centralia, WA 98531-9072
Phone (360) 736-2853

National Provider Directory

National Provider Directory
Tax ID family
Medical Massage Acupuncture PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2923 Jackson Hwy
Ste B
Chehalis, WA 98532
Phone (360) 996-4778

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1902115371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319072",
            "telephone_number": "360-736-2853",
            "fax_number": "360-736-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COOKS HILL RD",
            "address_2": "SUITE A",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319072",
            "telephone_number": "360-736-2853",
            "fax_number": "360-736-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL MASSAGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/LMP",
        "authorized_official_telephone_number": "360-736-2853",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00013686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.