NORTHWEST THERAPEUTIC MASSAGE (NPI# 1619365830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619365830 |
| Entity Type | Organization |
| Organization Name | NORTHWEST THERAPEUTIC MASSAGE |
| Practice Address |
4113 Bridgeport Way W Ste B University Place WA 98466-4325 |
| Practice Telephone | 2535645828 |
| Practice Fax Number | 2535640115 |
| Mailing Telephone | 2535645828 |
| Mailing Fax Number | 2535640115 |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2014-12-23 |
| Authorized Official Name | MR. BRUCE CORNS (OWNER/MASSAGE THERAPIST) |
| Authorized Official Telephone | 2535645828 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 60401382 | WA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801294566 | Northwest Therapeutic Massage | Clinic/Center | 4113 Bridgeport Way W Ste Eb, University Place, WA 98466-4325 | 2014-12-11 |
| 1750759585 | Northwest Therapeutic Massage | Massage Therapist | 4113 Bridgeport Way W, Suite B, University Place, WA 98466-4325 | 2015-09-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | NORTHWEST THERAPEUTIC MASSAGE, INC. | 4113 Bridgeport Way W, Ste. B, University Place, WA 98466 |
| Street Address |
4113 BRIDGEPORT WAY W STE B |
| City | UNIVERSITY PLACE |
| State | WA |
| Zip Code | 98466-4325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922147016 | Bruce Edward Corns | Specialist | 4113 Bridgeport Way W Ste B, University Place, WA 98466-4325 | 2007-02-05 |
| 1467944744 | Nikki Jane Frantz | Massage Therapist | 4113 Bridgeport Way W Ste B, University Place, WA 98466-4325 | 2018-06-03 |
| 1720460983 | Aaron Amon Greene | Massage Therapist | 4113 Bridgeport Way W Ste B, University Place, WA 98466-4325 | 2015-06-24 |
| 1811228646 | Holly Hunt | Massage Therapist | 4113 Bridgeport Way W Ste B, University Place, WA 98466-4325 | 2010-01-18 |
| 1780724948 | Suzie Elaine Price | Specialist | 4113 Bridgeport Way W Ste B, University Place, WA 98466-4325 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499215 | Julie Mccartney | Counselor | 7610 40th St W Ste 20, University Place, WA 98466 | 2019-07-19 |
| 1033682752 | Jms Corporate Services Group | In Home Supportive Care | 2621 70th Avenue West, Suite C, University Place, WA 98466 | 2019-01-04 |
| 1992270243 | Kathleen Marie Kulman | Massage Therapist | 4113 Bridgeport Avenue, Suite B, Tacoma, WA 98466 | 2018-10-12 |
| 1518441674 | Michala Lin Dymond-shaw | Speech-Language Pathologist | 3725 Grandview Dr W, University Place, WA 98466 | 2018-09-24 |
| 1770001133 | Micky Patrick Cates | Physician Assistant | 1924 70th Ave West, Apt E5, University Place, WA 98466 | 2017-09-06 |
| 1386160984 | Stephanie Herrala | Dentist | Okubo Dental Clinic 11582 C St, Jblm, WA 98466 | 2017-08-16 |
| 1033581640 | Jay Hyuck Sung | Dentist | 3670 Bridgeport Way W, Unit B, University Place, WA 98466 | 2015-10-22 |
| 1174951867 | Adrienne Holliday | Occupational Therapy Assistant | 3717 Grandview Drive W, University Place, WA 98466 | 2013-10-16 |
| 1598106650 | Maricris Pang Espino | Registered Nurse | 1541 Cottonwood Avenue, Fircrest, WA 98466 | 2013-07-17 |
| 1417393653 | Nurhan Karakas | Counselor | 9330 59th Ave Sw, Lakewood, WA 98466 | 2013-05-15 |
| Find all providers in zip 98466 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500814 | Foundation Speech Language Learning | Specialist | 7406 27th St W Ste 24a, University Place, WA 98466-4636 | 2020-05-22 |
| 1427474980 | Tammy Lynne Gagnon | Specialist | 8425 40th St W, University Place, WA 98466-2041 | 2014-03-07 |
| 1417283557 | Lisa Ann Kingsley | Specialist | 7321 58th Street Ct W, #303, University Place, WA 98467-4723 | 2009-10-24 |
| 1750514832 | Ashley Elynn Elmer | Specialist | 8313 29th St W, Apt. C, University Place, WA 98466-2706 | 2009-08-24 |
| 1558590521 | Rachel Antonina Iacobazzi Riecan | Specialist | 8514 49th St W, University Place, WA 98467-1810 | 2009-07-10 |
| 1629266499 | Todd D Valentine | Specialist | 4009 Bridgeport Way W, Suite E-2, University Place, WA 98466-4326 | 2007-10-05 |
| 1205951910 | Pacific Northwest Plastic Surgery, Ps | Specialist | 5016 Bridgeport Way W, Suite A, University Place, WA 98467-2039 | 2007-03-20 |
| 1114066990 | Renee Charise Probst | Specialist | 4103 Bridgeport Way W Ste C, University Place, WA 98466-4332 | 2007-02-06 |
| 1922147016 | Bruce Edward Corns | Specialist | 4113 Bridgeport Way W Ste B, University Place, WA 98466-4325 | 2007-02-05 |
| 1942363619 | Sara Sloan Campbell | Specialist | 8404 27th St W, University Place, WA 98466-2723 | 2006-12-17 |
| Find all providers in UNIVERSITY PLACE | ||||
| City | UNIVERSITY PLACE |
| Zip Code | 98466 |
Please comment or provide details below to improve the information on NORTHWEST THERAPEUTIC MASSAGE.
| 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.