ROOTED SPRUCE MASSAGE AND BODYWORK (NPI# 1366092132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366092132 |
| Entity Type | Organization |
| Organization Name | ROOTED SPRUCE MASSAGE AND BODYWORK |
| Practice Address |
120 Ne 117th Ave Rm 8 Vancouver WA 98684-5020 |
| Practice Telephone | 9717701360 |
| Mailing Telephone | 9717701360 |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2019-09-13 |
| Authorized Official Name | IMUYA LEE DOOLEY MCDANIEL (OWNER) |
| Authorized Official Telephone | 9717701360 |
| Authorized Official Credential | LMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
120 NE 117TH AVE RM 8 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-5020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285291849 | Pacifica Sylvan Park LLC | Alzheimer Center (Dementia Center) | 2400 Ne 112th Avenue, Vancouver, WA 98684 | 2019-05-20 |
| 1699242826 | Heidi Ericka Jackson | Registered Nurse | 15606 Ne 12th Way, Vancouver, WA 98684 | 2018-10-25 |
| 1477076727 | Brian Benasa Bardeloza | Dentist | 605 Se 164th Ave Ste 103, Vancouver, WA 98684 | 2017-07-19 |
| 1992226062 | Judith Moreno-castro | Massage Therapist | 2501 Ne 138th Ave., #60, Vancouver, WA 98684 | 2017-06-29 |
| 1346790706 | Samuel Joonsang Lee | Registered Nurse | 501 Se 172nd Ave Ste 210, Vancouver, WA 98684 | 2016-10-10 |
| 1912353178 | Cheryl A. Hamilton-jefferson | Counselor | 11818 Se Mill Plain Blvd Ste 311g, Vancouver, WA 98684 | 2016-05-06 |
| 1063866424 | Kim Forgione | Optometrist | 1900 Ne 162nd Ave Ste D103, Vancouver, WA 98684 | 2016-04-21 |
| 1700254257 | Desiree Haggart | Registered Nurse | 406 Se 131st St., Suite A101, Vancouver, WA 98684 | 2015-09-14 |
| 1215318068 | Paige M. King | Behavioral Analyst | 11818 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684 | 2015-06-17 |
| 1417354366 | Amanda Hilkey, Lmp | Massage Therapist | 108 Se 24th Ave, Ste 9, Vancouver, WA 98684 | 2014-11-20 |
| Find all providers in zip 98684 | ||||
| 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 |
|---|---|---|---|---|
| 1417558743 | Erin Claire Stafford | Massage Therapist | 709 Nw 120th St, Vancouver, WA 98685-2495 | 2020-11-03 |
| 1225650112 | Zachary Dodds | Massage Therapist | 12314 Nw 42nd Ct, Vancouver, WA 98685 | 2020-05-13 |
| 1205469871 | Gary James Wartella II | Massage Therapist | 21201 Ne 58th St Unit 1, Vancouver, WA 98682-9660 | 2020-02-21 |
| 1114550126 | Alexander J Lindo | Massage Therapist | 2125 E 8th St, Vancouver, WA 98661-4301 | 2020-02-18 |
| 1659918472 | Mckenzi Roulette | Massage Therapist | 4000 Ne 109th Ave Unit 68, Vancouver, WA 98682-5718 | 2019-12-01 |
| 1487297313 | Rachel Ann Tudor | Massage Therapist | 9618 Ne Fourth Plain Blvd, Vancouver, WA 98662-6107 | 2019-10-23 |
| 1982245064 | Andrea Joy | Massage Therapist | 1401 Se 164th Ave Ste 130, Vancouver, WA 98683-9612 | 2019-09-30 |
| 1083265722 | Rob Elmer William Anderson | Massage Therapist | 6509 Ne 45th Way, Vancouver, WA 98661-2893 | 2019-09-24 |
| 1477106581 | Steven J Zerfing | Massage Therapist | 4903 Ne St James Rd Apt 30, Vancouver, WA 98663-1900 | 2019-07-17 |
| 1194382093 | Jose Angel Delapaz | Massage Therapist | 400 E Evergreen Blvd Ste 322a, Vancouver, WA 98660-3385 | 2019-05-26 |
| Find all providers in VANCOUVER | ||||
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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.