AUTUMN LUKEZECH (NPI# 1134638521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134638521 |
| Entity Type | Individual |
| Full Name | AUTUMN LUKEZECH |
| Practice Address |
102 S Euclid Ave Ste 111 Sandpoint ID 83864-4916 |
| Mailing Address |
33071 Highway 200 Sandpoint ID 83864-9066 |
| Practice Telephone | 5125169144 |
| Mailing Telephone | 5125169144 |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2017-09-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MAS-2902 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
102 S EUCLID AVE STE 111 |
| City | SANDPOINT |
| State | ID |
| Zip Code | 83864-4916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053827840 | Brianna Thoreson, Msw, Lcsw, Pllc | Clinic/Center | 102 S Euclid Ave Ste 111, Sandpoint, ID 83864-4916 | 2017-12-16 |
| 1154836427 | Bambi Lassen, Msw, Lcsw, Pllc | Social Worker | 102 S Euclid Ave Ste 111, Sandpoint, ID 83864-4916 | 2017-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842600 | Deblaquiere Enterprises, Inc. | Pharmacy | 1319 Hwy 2, Suite A, Sandpoint, ID 83864 | 2020-05-07 |
| 1245867670 | Kimberly Sue Batchelder | Massage Therapist | Sandpoint Medical Massage & Bodyworks, LLC, 515 Pine Street Ste G., Sandpoint, ID 83864 | 2020-03-25 |
| 1699309963 | Ckam Rejuvenation Center LLC | Massage Therapist | 1315 Us-2, #5, Sandpoint, ID 83864 | 2020-02-26 |
| 1427602986 | Alpine Hand Therapy Inc | Physical Medicine & Rehabilitation | 1205 Hwy 2, Suite 102, Sandpoint, ID 83864 | 2019-08-01 |
| 1295388536 | Momentum Medical Massage and Personal Training, LLC | Massage Therapist | 1013 W Lake St, Sandpoint, ID 83864 | 2019-07-16 |
| 1629508932 | Karen Elizabeth Vollmer-poseley | Counselor | 506 N. 4th Ave, Sandpoint, ID 83864 | 2017-06-19 |
| 1760912042 | Gregory Jon Anthony Prins | Dentist | 1305 Highway 2 West, Sandpoint, ID 83864 | 2017-06-19 |
| 1730547084 | Charity Catlin | Midwife | 204 N 4th Ave #2355, Sandpoint, ID 83864 | 2016-02-02 |
| 1497148860 | Loftus Family Dental - Sandpoint Pllc | Dentist | 1310 Ponderosa Drive, Suite A, Sandpoint, ID 83864 | 2015-03-10 |
| 1215365523 | Tamarack Treatment and Counseling Center, Pllc | Counselor | 101 N. Boyer Ave, Sandpoint, ID 83864 | 2013-10-23 |
| Find all providers in zip 83864 | ||||
| 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 |
|---|---|---|---|---|
| 1902429020 | Joline Elizabeth Genay-wolf | Massage Therapist | 219 Cedar St Ste B, Sandpoint, ID 83864-1460 | 2020-05-22 |
| 1790306751 | Nova Orion Layton | Massage Therapist | 1315 Highway 2, Sandpoint, ID 83864-2724 | 2020-04-30 |
| 1104447457 | Victoria Scheidel | Massage Therapist | 1315 Highway 2 Ste 5, Sandpoint, ID 83864-2724 | 2020-04-28 |
| 1245867670 | Kimberly Sue Batchelder | Massage Therapist | Sandpoint Medical Massage & Bodyworks, LLC, 515 Pine Street Ste G., Sandpoint, ID 83864 | 2020-03-25 |
| 1699309963 | Ckam Rejuvenation Center LLC | Massage Therapist | 1315 Us-2, #5, Sandpoint, ID 83864 | 2020-02-26 |
| 1841832029 | Maia Cassandra Gaddess | Massage Therapist | 1013 Lake St Ste 100, Sandpoint, ID 83864-5002 | 2019-10-09 |
| 1295388536 | Momentum Medical Massage and Personal Training, LLC | Massage Therapist | 1013 W Lake St, Sandpoint, ID 83864 | 2019-07-16 |
| 1104485341 | Quincy Rae Ulrich | Massage Therapist | 205 N 1st Ave, Sandpoint, ID 83864-1401 | 2019-06-11 |
| 1497274336 | Christopher Michael Kalinowski | Massage Therapist | 515 Pine St Ste G, Sandpoint, ID 83864-1658 | 2017-09-12 |
| 1558883967 | Constance Hammond | Massage Therapist | 102 S Euclid Ave Ste 109, Sandpoint, ID 83864-4916 | 2017-07-07 |
| Find all providers in SANDPOINT | ||||
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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.