STEPHEN C BOURDEAU (NPI# 1598980955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598980955 |
| Entity Type | Individual |
| Full Name | STEPHEN C BOURDEAU |
| Credential | LMP |
| Practice Address |
11821 Ne 128th St Suite C Kirkland WA 98034-7210 |
| Mailing Address |
790 Remington Blvd Bolingbrook IL 60440-4909 |
| Practice Telephone | 4252851250 |
| Practice Fax Number | 4252851255 |
| Mailing Telephone | 6302962222 |
| Mailing Fax Number | 6307599510 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2017-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00023394 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
11821 NE 128TH ST SUITE C |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-7210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023088374 | Timothy Hayes Massey | Orthopaedic Surgery | 11821 Ne 128th St, Suite A, Kirkland, WA 98034-7210 | 2006-01-26 |
| 1003351925 | Eric O'quinn | Physical Therapist | 11821 Ne 128th St, Ste C, Kirkland, WA 98034-7210 | 2017-01-02 |
| 1073981775 | Julie Foerster | Physical Therapist | 11821 Ne 128th St, Ste. C, Kirkland, WA 98034-7210 | 2015-09-11 |
| 1356718969 | Briana L Rogers | Physical Therapist | 11821 Ne 128th St, Ste C, Kirkland, WA 98034-7210 | 2015-08-31 |
| 1750774881 | Lisa Gleason | Dietitian, Registered | 11821 Ne 128th St, Ste C, Kirkland, WA 98034-7210 | 2015-03-13 |
| 1477953222 | Comprehensive Natural Medicine, Pllc | Non-Pharmacy Dispensing Site | 11821 Ne 128th St, Suite H, Kirkland, WA 98034-7210 | 2014-08-29 |
| 1134529183 | Virginia Haley | Physical Therapist | 11821 Ne 128th St, Ste C, Kirkland, WA 98034-7210 | 2014-08-27 |
| 1477979847 | Scott Schorer, L.ac., Eamp, Pllc | Acupuncturist | 11821 Ne 128th St, Suite H, Kirkland, WA 98034-7210 | 2014-03-10 |
| 1922346360 | Carley Moore | Specialist | 11821 Ne 128th St, Suite B, Kirkland, WA 98034-7210 | 2013-01-18 |
| 1992906481 | Galen Brett | Massage Therapist | 11821 Ne 128th St, Suite C, Kirkland, WA 98034-7210 | 2007-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| 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 |
|---|---|---|---|---|
| 1710591375 | Parnisia L Duckworth-thomas | Massage Therapist | 11314 Ne 149th St, Kirkland, WA 98034-1006 | 2020-09-01 |
| 1164063657 | Dahlia Alicia Ohashi | Massage Therapist | 250 Market St Ste 102, Kirkland, WA 98033-4811 | 2019-10-05 |
| 1952886467 | Tarah Glover | Massage Therapist | 250 Market St Unit 102, Kirkland, WA 98033-6132 | 2018-10-01 |
| 1023523925 | Patricia Alyse Strait | Massage Therapist | 14012 Juanita Dr Ne Apt C3, Kirkland, WA 98034-9741 | 2017-12-13 |
| 1205296662 | Yang Wellness Pllc | Massage Therapist | 13033 Ne 70th Pl Ste 4, Kirkland, WA 98033-8657 | 2016-02-29 |
| 1508221953 | Washington Health Associates | Massage Therapist | 12305 120th Ave Ne Ste A, Kirkland, WA 98034-6921 | 2015-12-29 |
| 1245695352 | Ron Massey | Massage Therapist | 11406 Ne 112th St, Kirkland, WA 98033 | 2015-12-17 |
| 1902271109 | Cameron Leigh Stewart | Massage Therapist | 14310 130th Pl Ne, Kirkland, WA 98034-1301 | 2015-12-14 |
| 1346614567 | Ibrahim Ahmadkhanlou | Massage Therapist | 13213 100th Pl Ne, Kirkland, WA 98034-2046 | 2015-11-26 |
| 1194103895 | Kristen Rosenberger Jawad | Massage Therapist | 12004 81st Ave Ne, Kirkland, WA 98034-5815 | 2015-05-13 |
| Find all providers in KIRKLAND | ||||
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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.