CROSSFUNCTION SPORTS MASSAGE, PLLC (NPI# 1316476112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316476112 |
| Entity Type | Organization |
| Organization Name | CROSSFUNCTION SPORTS MASSAGE, PLLC |
| Practice Address |
16000 Bothell Everett Hwy Unit 161 Mill Creek WA 98012-1742 |
| Mailing Address |
15433 Country Club Dr Unit A202 Mill Creek WA 98012-1745 |
| Practice Telephone | 4255953436 |
| Practice Fax Number | 4255953436 |
| Mailing Telephone | 4254188588 |
| Mailing Fax Number | 4255953436 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2017-06-06 |
| Authorized Official Name | JENNY LYNN MAPES (OWNER) |
| Authorized Official Telephone | 4255953436 |
| Authorized Official Credential | LMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA60410229 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PERSONAL NPI NUMBER | 1275949349 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CROSSFUNCTION SPORTS MASSAGE, PLLC | 16000 Bothell Everett Hwy Ste 161, Mill Creek, WA 98012-1742 |
| Washington State Corporations | CROSSFUNCTION SPORTS MASSAGE, PLLC | 805 164th St Se, 100, Mill Creek, WA 98012-6316 |
| Street Address |
16000 BOTHELL EVERETT HWY UNIT 161 |
| City | MILL CREEK |
| State | WA |
| Zip Code | 98012-1742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609347616 | Tahoe Tooch | Massage Therapist | 16000 Bothell Everett Hwy Unit 161, Mill Creek, WA 98012-1742 | 2018-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502032 | Malia Van-frances Chase | Behavioral Analyst | 18311 Bothel-everett Hwy, Suite 260, Bothell, Wa, WA 98012 | 2020-09-14 |
| 1154951804 | Thea E Byrne | Physical Therapist | 6030 Bothell Everett Hwy, #140, Mill Creek, WA 98012 | 2020-01-22 |
| 1861975526 | Jenifer Rae Denormandie | Pharmacist | 14529 North Creek Drive Apt B210, Mill Creek, WA 98012 | 2018-09-10 |
| 1780161760 | Azadeh Fariba | Naturopath | 15411 40th Dr Se, Bothell, WA 98012 | 2018-07-23 |
| 1720572902 | Rickey Lee Mcgregor | Counselor | 16300 Mill Creek Blvd, Suite 204, Mill Creek, WA 98012 | 2018-06-20 |
| 1306349865 | Rudi Lauren Romaine | Behavioral Analyst | 18311 Bothell-everett Hwy, Suite 260, Bothell, WA 98012 | 2018-03-12 |
| 1164961025 | Wickler Behavioral Consulting | Behavioral Analyst | 632 182nd Street Se, Bothell, WA 98012 | 2017-02-13 |
| 1588026413 | Nathan Earl Crawford | Massage Therapist | 18930 Bothell Everett Hwy, D302, Bothell, WA 98012 | 2016-03-21 |
| 1144618083 | Jocelyn Enabulele | Counselor | 19105 Waxen Road, Bothell, WA 98012 | 2014-12-30 |
| 1124426846 | Teeth R Us | Dentist | 1908 201 Pl Se Suite #201, Bothell, WA 98012 | 2014-12-11 |
| Find all providers in zip 98012 | ||||
| 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 |
|---|---|---|---|---|
| 1386119709 | Crossfunction Sports Massage | Massage Therapist | 16000 Bothell Everett Hwy Ste 161, Mill Creek, WA 98012-1742 | 2018-10-12 |
| 1881171643 | Kathryn Sordahl | Massage Therapist | 16212 Bothell Everett Hwy Ste E, Mill Creek, WA 98012-1235 | 2018-07-25 |
| 1598250391 | Emily Jane Gammell | Massage Therapist | 16708 Bothell Everett Hwy Ste 202, Mill Creek, WA 98012-6345 | 2018-06-25 |
| 1568954683 | Beverly Nicole Prater | Massage Therapist | 1231 Mill Creek Blvd Apt I202, Mill Creek, WA 98012-3086 | 2018-06-04 |
| 1023526597 | Tina Lepeska | Massage Therapist | 13416 Bothell Everett Hwy Ste 201, Mill Creek, WA 98012-5311 | 2018-01-17 |
| 1114430535 | Emily Boyd | Massage Therapist | 15418 Main St Unit M106, Mill Creek, WA 98012-9021 | 2017-11-07 |
| 1720519978 | Elva Elizabeth Cosgrave | Massage Therapist | 1212 144th Pl Se, Mill Creek, WA 98012-1384 | 2017-03-21 |
| 1326581885 | Megen Smith | Massage Therapist | 15021 Main St Ste K, Mill Creek, WA 98012-1651 | 2016-11-30 |
| 1093257651 | Yekatrina Solop | Massage Therapist | 15418 Main St Unit 106, Mill Creek, WA 98012-9040 | 2016-11-14 |
| 1487005955 | Eric Heidel | Massage Therapist | 1401 144th Pl Se, Mill Creek, WA 98012-1340 | 2016-06-27 |
| Find all providers in MILL CREEK | ||||
| City | MILL CREEK |
| Zip Code | 98012 |
Please comment or provide details below to improve the information on CROSSFUNCTION SPORTS MASSAGE, PLLC.
| 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.