MISS TRACY L MCCLELLAN (NPI# 1164647228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164647228 |
| Entity Type | Individual |
| Full Name | MISS TRACY L MCCLELLAN |
| Credential | L.M.P. |
| Practice Address |
401 N Pacific Ave Kelso WA 98626-3515 |
| Mailing Address |
4400 Ocean Beach Hwy Sp. #12 Longview WA 98632-5080 |
| Practice Telephone | 3605777191 |
| Mailing Telephone | 3605777191 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00020641 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
401 N PACIFIC AVE |
| City | KELSO |
| State | WA |
| Zip Code | 98626-3515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730581877 | Wrothell Funchess | Counselor | 1645 Bowmont Ave, Kelso, WA 98626 | 2014-09-19 |
| 1427457688 | Julie Dalen | Counselor | 309 Oak Street, Kelso, WA 98626 | 2014-08-13 |
| 1033468822 | Rene Kerry Bohannon-oxford | Counselor | 2707 Pacific Ave North, Kelso, WA 98626 | 2012-09-07 |
| 1447535737 | Nichole Kathleen Allee | Massage Therapist | 109 Nw 1st St., Kelso, WA 98626 | 2011-10-18 |
| 1689991655 | Zachariah Kramer | Radiology | 700 Lincoln Street Suite 100, Longview Radiologists, Kelso, WA 98626 | 2010-04-29 |
| 1508007071 | Robert Lee Blair | Registered Nurse | 119 Blackburn Lane, Kalama, WA 98626 | 2009-03-13 |
| 1942318829 | Imholte & Anderson Pllc | Dentist | 409 West Main Street, Kelso, WA 98626 | 2006-08-29 |
| 1922088723 | James Bevan Hollingsworth | Pharmacist | 204 S Pacific Ave, Kelso, WA 98626 | 2006-01-18 |
| 1972021087 | Adreia Jenice Jessop | Registered Nurse | 300 Oak St, Kelso, WA 98626 | 2017-09-08 |
| 1023567310 | Charlene Han | Pharmacist | 205 Three Rivers Dr, Kelso, WA 98626 | 2016-09-27 |
| Find all providers in zip 98626 | ||||
| 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 |
|---|---|---|---|---|
| 1568889764 | Kimberly Gustin | Massage Therapist | 2418 Burcham St, Kelso, WA 98626-5141 | 2014-03-25 |
| 1447535737 | Nichole Kathleen Allee | Massage Therapist | 109 Nw 1st St., Kelso, WA 98626 | 2011-10-18 |
| 1891936894 | Kimberlee A Mcgrath | Massage Therapist | 802 Allen St, Kelso, WA 98626-4406 | 2009-03-20 |
| 1669922845 | Mirror Images of Beauty Inc | Massage Therapist | 207 Allen St, Kelso, WA 98626-3403 | 2016-10-11 |
| 1336586304 | Jennifer M Fraser | Massage Therapist | 109 Nw 1st Ave, Kelso, WA 98626-1726 | 2013-05-30 |
| 1932420163 | Jana Suzanne Leach | Massage Therapist | 208 Church St, Kelso, WA 98626-3409 | 2010-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346177 | Franco Garibaldi | Massage Therapist | 8120 378th Ave Se, Snoqualmie, WA 98065-9338 | 2020-11-06 |
| 1073114815 | Michael Paul Frietze | Massage Therapist | 519 Sw Cascade Ave, Chehalis, WA 98532-3213 | 2020-11-06 |
| 1417558305 | Madelyn Leigh Thomas | Massage Therapist | 2202 6th Ave, Tacoma, WA 98403-1049 | 2020-11-05 |
| 1912508094 | Catelyn Renee Wesley | Massage Therapist | 211 Marty Loop, Woodland, WA 98674-7223 | 2020-11-04 |
| 1154922250 | Wanju S Kellams | Massage Therapist | 677 Woodland Square Loop Se # A-8, Lacey, WA 98503-1000 | 2020-11-04 |
| 1417558743 | Erin Claire Stafford | Massage Therapist | 709 Nw 120th St, Vancouver, WA 98685-2495 | 2020-11-03 |
| 1063013332 | Andrea L Yu | Massage Therapist | 7207 265th St Nw Ste 102, Stanwood, WA 98292-6274 | 2020-11-03 |
| 1689274250 | Francine Marie Morales | Massage Therapist | 1320 Worrall Dr, Bremerton, WA 98310-3629 | 2020-10-31 |
| 1255931994 | Lotus Lounge Corporation | Massage Therapist | 200 Auburn Ave Ste 3, Auburn, WA 98002-5015 | 2020-10-30 |
| 1538769088 | Alison K Rostholder-harris | Massage Therapist | 1202 E Pine St Unit 101, Seattle, WA 98122-3929 | 2020-10-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MISS TRACY L MCCLELLAN.
| 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.