MS. LISA MARIE WICKLUND (NPI# 1609304476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609304476 |
| Entity Type | Individual |
| Full Name | MS. LISA MARIE WICKLUND |
| Credential | LMT |
| Practice Address |
9140 Baltimore St Ne Ste 140-5 Blaine MN 55449-4382 |
| Practice Telephone | (612) 481-9718 |
| Mailing Telephone | 6124819718 |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2017-05-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 17-07455 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104057 | Lisa Baker Wicklund | Counselor | 6750 Hillcrest Plaza Dr Ste 206, Dallas, TX 75230-1438 | 2020-11-04 |
| Street Address |
9140 BALTIMORE ST NE STE 140-5 |
| City | BLAINE |
| State | MN |
| Zip Code | 55449-4382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736368 | Landon Thomas Case | Dentist | 10729 Town Square Drive Ne, Ste 100, Blaine, MN 55449 | 2020-07-02 |
| 1881168441 | Ear Institutes, LLC | Otolaryngology | 4365 Pleasant Ridge Dr Ne, Suite 106, Blaine, MN 55449 | 2019-01-17 |
| 1841776242 | Kristin Broback | Nurse Practitioner | 10705 Town Square Dr Ne #100, Blaine, MN 55449 | 2018-07-18 |
| 1043719016 | Robin Lynn Broen | Registered Nurse | 3012 129th Ave Ne, Blaine, MN 55449 | 2018-02-06 |
| 1194197368 | Lund Health Professional Corporation | Chiropractor | 1360 101st Ave Ne, Suite 140, Blaine, MN 55449 | 2015-10-27 |
| 1871989806 | Blaine Wp II, LLC | Assisted Living Facility | 12402 Jamestown Street Ne, Blaine, MN 55449 | 2015-04-07 |
| 1154761633 | Jean Budge | Marriage & Family Therapist | 11800 Aberdeen Street Ne, Suite 100, Blaine, MN 55449 | 2013-06-28 |
| 1295013498 | Jeff K Yu | Veterinarian | 11850 Aberdeen St Ne, Blaine, MN 55449 | 2011-07-22 |
| 1528394707 | Julie Ann Eibensteiner | Physical Therapist | 11304 Davenport Circle Ne #a, Minneapolis, MN 55449 | 2009-10-23 |
| 1871725333 | Deborah Kathryn Zongo | Nurse Practitioner | 10190 Baltimore St Ne Ste 100, Blaine, MN 55449 | 2009-08-18 |
| Find all providers in zip 55449 | ||||
| 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 |
|---|---|---|---|---|
| 1346645710 | Teresa Meyer | Massage Therapist | 2456 H Street Rd, Blaine, WA 98230-8904 | 2014-10-28 |
| 1386063121 | Andrea Backstrom | Massage Therapist | 865 124th Ave Ne, Blaine, MN 55434-3169 | 2014-04-09 |
| 1154759173 | Jennifer Cunningham | Massage Therapist | 3865 97th Ln Ne, Blaine, MN 55014 | 2013-10-30 |
| 1396171815 | Brenda Jean Hagen | Massage Therapist | 7976 Kickerville Rd, Blaine, WA 98230-9249 | 2013-09-16 |
| 1467890061 | Stephana Campion | Massage Therapist | 4070 Fishermans Bend Ln, Blaine, WA 98230-9177 | 2013-06-05 |
| 1821300609 | Kari J Hrutfiord | Massage Therapist | 366 H St, Blaine, WA 98230-4109 | 2010-07-08 |
| 1871731703 | Sarah Joy Karman | Massage Therapist | 1061 109th Ave Ne Ste D, Blaine, MN 55434-3847 | 2009-01-30 |
| 1609011360 | Caralyn Anne Olson | Massage Therapist | 1061 109th Ave Ne, Blaine, MN 55434-3846 | 2008-12-10 |
| 1568627503 | Amber Nicole Rice | Massage Therapist | 6906 Petticote Ln, Blaine, WA 98230-9634 | 2008-07-18 |
| 1225643893 | Sadie Elise Rasar | Massage Therapist | 245 H St, Blaine, WA 98230-4021 | 2020-09-10 |
| Find all providers in BLAINE | ||||
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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.