CLASSIC MASSAGE CLINIC, PLLC (NPI# 1265606198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265606198 |
| Entity Type | Organization |
| Organization Name | CLASSIC MASSAGE CLINIC, PLLC |
| Practice Address |
1101 Avenue D Ste D207 Snohomish WA 98290-2004 |
| Practice Telephone | 3605630209 |
| Practice Fax Number | 3605630243 |
| Mailing Telephone | 3605630209 |
| Mailing Fax Number | 3605630243 |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |
| Authorized Official Name | MS. KELLY L ENGESETH (MASSAGE THERAPIST/OWNER) |
| Authorized Official Telephone | 3605630209 |
| Authorized Official Credential | LMP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00013819 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CLASSIC MASSAGE CLINIC, PLLC | 1101 Avenue D Ste C106, Snohomish, WA 98290 |
| Street Address |
1101 AVENUE D STE D207 |
| City | SNOHOMISH |
| State | WA |
| Zip Code | 98290-2004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730232034 | Kelly Lyn Engeseth | Massage Therapist | 1101 Avenue D Ste D207, Snohomish, WA 98290-2004 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185579 | Payton Helene Lewis | Massage Therapist | 1101 Ave D, C-106, Snohomish, WA 98290 | 2019-10-09 |
| 1225542921 | Pacifica Sl Snohomish | Assisted Living Facility | 1124 Pine Avenue, Snohomish, WA 98290 | 2017-11-17 |
| 1649781469 | Julia Miller | Behavioral Analyst | 2621 Bickford Ave Ste C, Snohomish, WA 98290 | 2017-10-19 |
| 1417315821 | Sherrie June Cooper | Speech-Language Pathologist | 1131 Silva Street, Snohomish, WA 98290 | 2016-02-01 |
| 1689067514 | Gladdie Altura | Speech-Language Pathologist | 12125 Chain Lake Rd, Snohomish, WA 98290 | 2015-03-17 |
| 1740618321 | Rebekah Joanne Oldenkamp | Naturopath | 110 Cedar Avenue, Suite 101, Snohomish, WA 98290 | 2013-10-17 |
| 1356779151 | Cassandra Hurd | Naturopath | 110 Cedar Ave Apt 101, Snohomish, WA 98290 | 2013-10-15 |
| 1982937801 | Elisa Madeline Chimienti | Massage Therapist | 1610 145th Ave. S.e., Snohomish, WA 98290 | 2009-09-10 |
| 1144452319 | Crystal L Blankinship | Counselor | 1830 Bickford Ave Ste 211, Snohomish, WA 98290 | 2009-08-20 |
| 1649417528 | Sondra Deschell | Reflexologist | 127 Ave A, Ste 2b, Snohomish, WA 98290 | 2009-01-14 |
| Find all providers in zip 98290 | ||||
| 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 |
|---|---|---|---|---|
| 1376185579 | Payton Helene Lewis | Massage Therapist | 1101 Ave D, C-106, Snohomish, WA 98290 | 2019-10-09 |
| 1912557893 | Leo Alonzo Atregenio | Massage Therapist | 5017 135th Pl Se, Snohomish, WA 98296-5218 | 2019-09-12 |
| 1467936328 | Susan Buckholz | Massage Therapist | 1207 13th St Ste G, Snohomish, WA 98290-2000 | 2018-09-18 |
| 1346720497 | Morgan Rae David | Massage Therapist | 1101 Avenue D Ste C106, Snohomish, WA 98290-2083 | 2018-08-17 |
| 1245748383 | Matthew Frederick Wysocki | Massage Therapist | 5118 Bosworth Dr, Snohomish, WA 98290-7700 | 2018-01-10 |
| 1033634068 | Aaron Jason Kondracki | Massage Therapist | 1808 181st Ave Ne, Snohomish, WA 98290-4435 | 2017-08-10 |
| 1699207688 | Julia O'neil | Massage Therapist | 6412 130th St Se, Snohomish, WA 98296-8999 | 2017-03-30 |
| 1356872261 | Valerie Martinez | Massage Therapist | 19417 Badke Rd, Snohomish, WA 98290-7270 | 2017-03-22 |
| 1790222776 | Brittany Reed | Massage Therapist | 322 Pine Ave, Snohomish, WA 98290-2541 | 2017-01-27 |
| 1487105565 | Kathleen Tawlks | Massage Therapist | 17416 Highway 9, Suite B, Snohomish, WA 98296-6304 | 2016-10-24 |
| Find all providers in SNOHOMISH | ||||
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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.