LINDA PHIMMAVONG (NPI# 1124493440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124493440 |
| Entity Type | Individual |
| Full Name | LINDA PHIMMAVONG |
| Credential | LMP |
| Practice Address |
7308 Bridgeport Way W Ste. 103 Lakewood WA 98499-8000 |
| Mailing Address |
4040 Orchard St W Ste. 100 Fircrest WA 98466-6606 |
| Practice Telephone | 2535828142 |
| Practice Fax Number | 2535828160 |
| Mailing Telephone | 2535641560 |
| Mailing Fax Number | 2535644449 |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2015-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA60590721 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
7308 BRIDGEPORT WAY W STE. 103 |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-8000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114921707 | Julian S Arroyo | Orthopaedic Surgery | 7308 Bridgeport Way W, Ste 201, Lakewood, WA 98499-8000 | 2005-06-10 |
| 1629518105 | Emily N Billings | Physical Therapist | 7308 Bridgeport Way W, Suite 103, Lakewood, WA 98499-8000 | 2017-03-02 |
| 1376910125 | Krista Elizabeth Guyll | Physician Assistant | 7308 Bridgeport Way W, Suite 201, Lakewood, WA 98499-8000 | 2015-08-27 |
| 1790151538 | Timothy J. Mann | Physical Therapist | 7308 Bridgeport Way W, Ste. 103, Lakewood, WA 98499-8000 | 2015-08-17 |
| 1790161578 | Emma Nicole Mcnutt | Massage Therapist | 7308 Bridgeport Way W, Ste. 103, Lakewood, WA 98499-8000 | 2015-08-04 |
| 1346655941 | Rachelle Kay Denman Sherwood | Physical Therapist | 7308 Bridgeport Way W, Ste. 103, Lakewood, WA 98499-8000 | 2014-06-23 |
| 1487065819 | Daniel Marler | Orthotist | 7308 Bridgeport Way W, Ste 204, Lakewood, WA 98499-8000 | 2014-05-20 |
| 1982014437 | Marvin Soriano | Physician Assistant | 7308 Bridgeport Way W, Suite 201, Lakewood, WA 98499-8000 | 2014-05-06 |
| 1427497668 | Mellissa Anne Selander | Massage Therapist | 7308 Bridgeport Way W, Ste. 103, Lakewood, WA 98499-8000 | 2013-06-20 |
| 1366880635 | Deanna Elaine Strohm | Massage Therapist | 7308 Bridgeport Way W, Ste. 103, Lakewood, WA 98499-8000 | 2013-06-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
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| 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 |
|---|---|---|---|---|
| 1043810229 | Rae Marie Minear | Massage Therapist | 1075 S Yukon St Ste 340, Lakewood, CO 80226-4333 | 2020-10-28 |
| 1881201960 | Hope Garcia | Massage Therapist | 12350 Del Amo Blvd Apt 2106, Lakewood, CA 90715-1723 | 2020-09-23 |
| 1649886011 | April Charlotte Crone | Massage Therapist | 1359 Kenilworth Ave, Lakewood, OH 44107-3102 | 2020-09-21 |
| 1912511833 | James Littlefield | Massage Therapist | 6002 Mount Tacoma Dr Sw, Lakewood, WA 98499-2703 | 2020-09-08 |
| 1558975318 | Clint Kaumualii Aalona | Massage Therapist | 6020 Main St Sw Ste C, Lakewood, WA 98499-6506 | 2020-08-31 |
| 1467060772 | Mile High Holistics, LLC | Massage Therapist | 1901 Kipling St, Lakewood, CO 80215-2822 | 2020-07-22 |
| 1376185561 | Nicholas Kanui Worst | Massage Therapist | 3 Beach Ln Sw, Lakewood, WA 98498-5703 | 2019-10-09 |
| 1548811532 | Kendra Pena-collazo | Massage Therapist | 10828 Gravelly Lake Dr Sw Ste 205, Lakewood, WA 98499-1346 | 2019-09-22 |
| 1063061828 | Meryl Elizabeth Haines | Massage Therapist | 1320 Simms St, Lakewood, CO 80401-4478 | 2019-09-04 |
| 1750938056 | Jessica Whyte | Massage Therapist | 334 S Teller St, Lakewood, CO 80226-7384 | 2019-08-21 |
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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.