CHALISE VANDERMYDE (NPI# 1205475704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205475704 |
| Entity Type | Individual |
| Full Name | CHALISE VANDERMYDE |
| Credential | LMT |
| Practice Address |
370 E South Temple Ste 150 Salt Lake City UT 84111-1279 |
| Mailing Address |
Po Box 711185 Salt Lake City UT 84171-1185 |
| Practice Telephone | 8019423311 |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | STATE LICENSE | 11334811-4701 | 01 |
| Street Address |
370 E SOUTH TEMPLE STE 150 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-1279 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508177635 | Tad S. Bergen | Audiologist | 370 E South Temple Ste 150, Salt Lake City, UT 84111-1279 | 2010-06-23 |
| 1356737902 | Sarah Johncock | Physical Therapist | 370 E South Temple Ste 150, Salt Lake City, UT 84111 | 2015-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551336 | Mary Ann Rush | Case Manager/Care Coordinator | 334 E. 100 S., Slc, UT 84111 | 2020-09-08 |
| 1790396554 | Stephanie G Mishenko | Military Health Care Provider | 344e 100s, Slc, UT 84111 | 2020-08-13 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1316421761 | Community Health Centers, Inc. | Social Worker | 610 S 200 E Ste #b, Salt Lake City, UT 84111 | 2018-09-21 |
| 1528545506 | Lauren Brittney Harman | Case Manager/Care Coordinator | 344 E. 100 S., Salt Lake City, UT 84111 | 2018-07-23 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1801390661 | Jaylee Marie Watman | Case Manager/Care Coordinator | 344 E. 100 S. Ste 301, Salt Lake City, UT 84111 | 2018-03-19 |
| 1467963918 | Victoira Julia Graham | Case Management | 344 East 100 South Ste 301, Salt Lake City, UT 84111 | 2017-10-23 |
| 1750805404 | Kayla Hymas | Behavioral Analyst | 243 E. 400 S., Slc, UT 84111 | 2017-08-02 |
| 1134643224 | Julie Peaslee | Counselor | 275 E South Temple Ste 110, Salt Lake City, UT 84111 | 2017-07-31 |
| Find all providers in zip 84111 | ||||
| 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 |
|---|---|---|---|---|
| 1235757303 | Annjanene Ojeda | Massage Therapist | 825 E 4800 S Ste 136, Salt Lake City, UT 84107-5545 | 2020-07-06 |
| 1154943439 | Baomei Sun | Massage Therapist | 58 E 2700 S, Salt Lake City, UT 84115-3132 | 2020-05-10 |
| 1952864423 | Joel Hanes | Massage Therapist | 1850 S 300 W Ste B, Salt Lake City, UT 84115-2399 | 2019-04-10 |
| 1942787007 | Koni Christensen | Massage Therapist | 5138 W Day Park Dr, Salt Lake City, UT 84120-2830 | 2018-07-22 |
| 1568949733 | Nikki R. Whitlock | Massage Therapist | 1155 E Wilmington Ave Ste 250, Salt Lake City, UT 84106-7808 | 2018-07-20 |
| 1932694775 | Christine Rae Hagler | Massage Therapist | 306 E Downington Ave Apt 4, Salt Lake City, UT 84115-2257 | 2018-06-25 |
| 1396249868 | Kathryn Perkins | Massage Therapist | 1104 E Ashton Ave Ste 118, Salt Lake City, UT 84106-2348 | 2018-03-20 |
| 1598279358 | David Francois Camoin | Massage Therapist | 750 E Bueno Ave, Salt Lake City, UT 84102-4102 | 2017-11-30 |
| 1891223996 | Jennifer Baird | Massage Therapist | 320 E 1st Ave Apt 4, Salt Lake City, UT 84103-2653 | 2017-06-01 |
| 1861937708 | Angela Francom | Massage Therapist | 329 E 300 S, Ste 102, Salt Lake City, UT 84111-2752 | 2017-01-02 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84111 |
Please comment or provide details below to improve the information on CHALISE VANDERMYDE.
| 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.