ALYSSA MARIE BAUCOM (NPI# 1750995551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750995551 |
| Entity Type | Individual |
| Full Name | ALYSSA MARIE BAUCOM |
| Practice Address |
14410 Se Petrovitsky Rd Ste 109 Renton WA 98058-8900 |
| Practice Telephone | 4252261856 |
| Practice Fax Number | 4252260231 |
| Mailing Telephone | 4252261856 |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA61081075 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
14410 SE PETROVITSKY RD STE 109 |
| City | RENTON |
| State | WA |
| Zip Code | 98058-8900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376695486 | Steven T Ryan | Chiropractor | 14410 Se Petrovitsky Rd Ste 109, Renton, WA 98058-8900 | 2007-01-17 |
| 1861031684 | Midway Healthcare Therapeutics LLC | Massage Therapist | 14410 Se Petrovitsky Rd Ste 109, Renton, WA 98058-8900 | 2019-12-26 |
| 1326220690 | Jasmine Ashley Adrian | Massage Therapist | 14410 Se Petrovitsky Rd Ste 109, Renton, WA 98058-8900 | 2007-11-28 |
| 1831370642 | Shannon Danelle Mcpherson | Massage Therapist | 14410 Se Petrovitsky Rd Ste 109, Renton, WA 98058-8900 | 2007-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639799471 | Fairwood Dental LLC | Dentist | 14250 Se 176th #j7, Renton, WA 98058 | 2020-04-22 |
| 1538641386 | Kenneth Graber | Physical Therapist | 17650 140th Avenue Sw, Suite B-07, Renton, WA 98058 | 2018-08-29 |
| 1508210154 | Lucy Johnson | Specialist/Technologist | 11808 Se 172nd Ln Apt N303, Renton, WA 98058 | 2016-04-20 |
| 1104253947 | Bertila Martinez | Dental Hygienist | 14600 Se 176th St #v4, Renton, WA 98058 | 2013-10-10 |
| 1326340456 | Tabatha Burris | Specialist | 14410 Petrovistsky Rd Se #109, Renton, WA 98058 | 2010-11-22 |
| 1295042570 | Hanh Q Nguyen | Pharmacist | 16940 116th Avenue Southeast, Renton, WA 98058 | 2010-09-08 |
| 1861692675 | Ernestine Johanna Rombouts | Counselor | 16205 128th Place Se, Renton, WA 98058 | 2007-07-19 |
| 1912100991 | Cara Rozell | Pharmacist | 400 South 43rd St, Renton, WA 98058 | 2007-06-07 |
| 1699821231 | Lynne Suzanne Balderson | Massage Therapist | 14410 Se Petrovitsky Rd #201, Renton, WA 98058 | 2007-01-26 |
| 1023173465 | Sara Jean Denherder | Massage Therapist | 17070 - 140th Ave Se, Renton, WA 98058 | 2006-12-26 |
| Find all providers in zip 98058 | ||||
| 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 |
|---|---|---|---|---|
| 1003429291 | Jill Rupp | Massage Therapist | 2100 Lake Washington Blvd N Apt K101, Renton, WA 98056-1455 | 2020-08-26 |
| 1538702394 | Ashi Empire Barefoot Massage | Massage Therapist | 16720 116th Ave Se Ste 5, Renton, WA 98058-5277 | 2019-10-24 |
| 1528610680 | Mark Gerhardt Schambers | Massage Therapist | 665 Bremerton Ave Ne, Renton, WA 98059-4747 | 2019-07-09 |
| 1982269114 | Jeffrey Frank Wasmer | Massage Therapist | 4808 Ne Sunset Blvd Apt B106, Renton, WA 98059-4283 | 2019-05-02 |
| 1669036554 | Ariana Feline Wren | Massage Therapist | 11314 Se 162nd St, Renton, WA 98055-5230 | 2019-04-25 |
| 1669959318 | Kewen Chen | Massage Therapist | 14024 163rd Pl Se, Renton, WA 98059-3662 | 2018-07-25 |
| 1992295703 | Celeste Marie Sage-tate | Massage Therapist | 15 S Grady Way Ste Ll19, Renton, WA 98057-3230 | 2018-05-16 |
| 1912496456 | Lashanda Mccurdy | Massage Therapist | 401 Olympia Avenue Ne, Renton, WA 98056 | 2018-05-09 |
| 1356855522 | Miguel Angel Banos | Massage Therapist | 3000 Ne 4th St., Renton, WA 98188 | 2017-11-27 |
| 1194237784 | Jie Yang | Massage Therapist | 19313 133rd Pl Se, Renton, WA 98058-7700 | 2017-11-03 |
| Find all providers in RENTON | ||||
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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.