MS. NICOLE M SMITH (NPI# 1871586073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871586073 |
| Entity Type | Individual |
| Full Name | MS. NICOLE M SMITH |
| Other Name | MS. NICOLE M BLUNK |
| Credential | LMP |
| Practice Address |
17650 140th Ave Se Renton WA 98058-6814 |
| Mailing Address |
Po Box 731269 Puyallup WA 98373-0060 |
| Practice Telephone | 4254300700 |
| Practice Fax Number | 4254300710 |
| Mailing Telephone | 2538406448 |
| Mailing Fax Number | 2538406340 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00010064 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | DEPT OF L&I | 181042 | 01 |
| WA | CRIME VICTIMS | 8930149 | 01 |
| WA | REGENCE BS | 4324SM | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712288 | Nicole Christina Smith | Advanced Practice Midwife | 8821 Foxgate Ct, Huber Heights, OH 45424-1103 | 2020-08-26 |
| 1396357356 | Nicole Lynn Smith | Behavior Technician | 1221 Maiden Choice Ln, Baltimore, MD 21229-5414 | 2020-08-20 |
| 1790393064 | Nicole L Smith | Nurse Practitioner | 505 Bingham Dr, Mcdonough, GA 30253-8050 | 2020-07-22 |
| 1144847807 | Nicole Francine Smith | Speech-Language Pathologist | 1643 Victoria Pointe Cir, Weston, FL 33327-1311 | 2020-06-29 |
| 1558981803 | Nicole Nadine Smith | Nurse Practitioner | 508 Wicklow Ct, Forest Hill, MD 21050-1644 | 2020-04-16 |
| 1568016921 | Nicole Renee Smith | Dentist | 8005 W 110th St Ste 220, Overland Park, KS 66210-2619 | 2019-07-24 |
| 1700448677 | Nicole E Smith | Registered Nurse | 4000 Bienville St Ste G, New Orleans, LA 70119-5163 | 2019-07-01 |
| 1720550809 | Nicole Sharron Smith | Nurse Practitioner | 3724 N 3rd St # 201, Phoenix, AZ 85012-2034 | 2018-12-29 |
| 1083184337 | Nicole Marie Smith | Psychologist | 124 Saddle Loop Unit B, Bigfork, MT 59911-3663 | 2018-11-29 |
| 1952880635 | Nicole Sharay Smith | In Home Supportive Care | 2150 Lincoln Ave, Cincinnati, OH 45224-1828 | 2018-08-13 |
| Street Address |
17650 140TH AVE SE |
| City | RENTON |
| State | WA |
| Zip Code | 98058-6814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245784206 | Mitsunaga Christopher Kubo | Massage Therapist | 17650 140th Ave Se, Ste B-07, Renton, WA 98058-6814 | 2016-08-08 |
| 1972955201 | Tessa M. Profita | Physical Therapist | 17650 140th Ave Se, Renton, WA 98058-6814 | 2016-07-11 |
| 1811368160 | Tara Becker | Physical Therapist | 17650 140th Ave Se, Ste B-07, Renton, WA 98058-6814 | 2015-10-13 |
| 1730598178 | Sandra Maria Ruiz | Physical Therapist | 17650 140th Ave Se, Suite B-07, Renton, WA 98058-6814 | 2014-08-11 |
| 1891040143 | Sarah Treacy Ellsworth | Physical Therapist | 17650 140th Ave Se, Ste B-07, Renton, WA 98058-6814 | 2012-07-23 |
| 1861758088 | Amy Hanako Almeida | Preventive Medicine | 17650 140th Ave Se, B7, Renton, WA 98058-6814 | 2012-04-02 |
| 1275821829 | Ashley Megan Fulkerson | Physical Therapist | 17650 140th Ave Se, Ste B-07, Renton, WA 98058-6814 | 2011-07-18 |
| 1174818926 | Mary E Culp | Massage Therapist | 17650 140th Ave Se, #b-07, Renton, WA 98058-6814 | 2011-06-09 |
| 1679882831 | Trista Bryelle Berlien | Physical Therapist | 17650 140th Ave Se, #b-07, Renton, WA 98058-6814 | 2010-10-05 |
| 1518279108 | Elizabeth Rose Butenko | Physical Therapist | 17650 140th Ave Se, #b-07, Renton, WA 98058-6814 | 2010-07-12 |
| Find all providers in the same location | ||||
| 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.