MS. ANA D LICANO (NPI# 1104057595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104057595 |
| Entity Type | Individual |
| Full Name | MS. ANA D LICANO |
| Credential | LMP |
| Practice Address |
310 Division St Grandview WA 98930-1359 |
| Mailing Address |
210 Ash St Grandview WA 98930-1319 |
| Practice Telephone | 5098823659 |
| Mailing Telephone | 5098825934 |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2009-08-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00024915 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
310 DIVISION ST |
| City | GRANDVIEW |
| State | WA |
| Zip Code | 98930-1359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003017476 | Fred C. Boboth O.d., P.s. | Optometrist | 403 N Euclid St, Grandview, WA 98930 | 2007-05-31 |
| 1639391253 | R. Scott Williams, D.d.s., P.s. | Dentist | 201 Euclid Street, Grandview, WA 98930 | 2007-05-03 |
| 1235224684 | Grandview School District | Local Education Agency (LEA) | 913 W 2nd Street, Grandview, WA 98930 | 2006-10-03 |
| 1063527661 | Jonathan F Volz Dds Pllc | Dentist | 310 E 2nd St, Grandview, WA 98930 | 2006-08-21 |
| 1790347623 | Rebecca Warnick | Registered Nurse | 1003 Wallace Way, Grandview, WA 98930 | 2019-07-01 |
| 1376026237 | Prosser Public Hospital District of Benton County | Clinic/Center | 1003 Wallace Way, Grandview, WA 98930 | 2018-09-07 |
| 1114414216 | Laboratory Corporation of America | Clinical Medical Laboratory | 240 Division St, Grandview, WA 98930 | 2018-04-16 |
| 1588151773 | Laboratory Corporation of America | Clinical Medical Laboratory | 1000 Wallace Way, Grandview, WA 98930 | 2018-04-13 |
| 1730686544 | Cindy Sun | Student in an Organized Health Care Education/Training Program | 1000 Wallace Way, Grandview, WA 98930 | 2018-04-09 |
| 1043711252 | Ruby Medina | Social Worker | 208 N. Euclid, Grandview, WA 98930 | 2018-02-22 |
| Find all providers in zip 98930 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457985772 | Richard Fix | Massage Therapist | 4748 County Road 1100, Grandview, TX 76050-4080 | 2020-02-25 |
| 1023238516 | Leslie P. Crone I | Massage Therapist | 312 Division St, Grandview, WA 98930-1359 | 2007-04-26 |
| 1801990072 | Bethany L Conklin | Massage Therapist | 211 Euclid Road, Grandview, WA 98930-1160 | 2006-09-11 |
| 1013488360 | Camacho Chiropractic and Sports Medicine LLC | Massage Therapist | 105 E 2nd St, Grandview, WA 98930-1345 | 2018-12-16 |
| 1710335666 | Lawrence Francis Lundhoy-wright | Massage Therapist | 1020 Main St, Grandview, MO 64030-2456 | 2016-06-01 |
| 1861732604 | Anderson Valley Chiropractic | Massage Therapist | 211 Euclid St, Grandview, WA 98930-1160 | 2013-02-14 |
| 1467683748 | Marisol Meza | Massage Therapist | 301 Division St, Grandview, WA 98930-1358 | 2009-08-04 |
| 1538227509 | Mathew Schneider | Massage Therapist | 1000 Wallace Way, Grandview, WA 98930-8805 | 2006-12-04 |
| 1912001173 | Leon Socorro Perez | Massage Therapist | 211 Euclid Rd., Grandview, WA 98930-1160 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346177 | Franco Garibaldi | Massage Therapist | 8120 378th Ave Se, Snoqualmie, WA 98065-9338 | 2020-11-06 |
| 1073114815 | Michael Paul Frietze | Massage Therapist | 519 Sw Cascade Ave, Chehalis, WA 98532-3213 | 2020-11-06 |
| 1417558305 | Madelyn Leigh Thomas | Massage Therapist | 2202 6th Ave, Tacoma, WA 98403-1049 | 2020-11-05 |
| 1912508094 | Catelyn Renee Wesley | Massage Therapist | 211 Marty Loop, Woodland, WA 98674-7223 | 2020-11-04 |
| 1154922250 | Wanju S Kellams | Massage Therapist | 677 Woodland Square Loop Se # A-8, Lacey, WA 98503-1000 | 2020-11-04 |
| 1417558743 | Erin Claire Stafford | Massage Therapist | 709 Nw 120th St, Vancouver, WA 98685-2495 | 2020-11-03 |
| 1063013332 | Andrea L Yu | Massage Therapist | 7207 265th St Nw Ste 102, Stanwood, WA 98292-6274 | 2020-11-03 |
| 1689274250 | Francine Marie Morales | Massage Therapist | 1320 Worrall Dr, Bremerton, WA 98310-3629 | 2020-10-31 |
| 1255931994 | Lotus Lounge Corporation | Massage Therapist | 200 Auburn Ave Ste 3, Auburn, WA 98002-5015 | 2020-10-30 |
| 1538769088 | Alison K Rostholder-harris | Massage Therapist | 1202 E Pine St Unit 101, Seattle, WA 98122-3929 | 2020-10-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.