OrganizationActive
State of Wellness
NPI 1265827240 · Massage Therapist · Vancouver, WA
Provider details
- NPI number
- 1265827240
- Entity type
- Organization
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Parent organization
- Robert Lacosse LLC
- Organization subpart
- Yes
- Authorized official
- Kelly Whittingham, Office Manager(971) 806-9595
- License
- MA 60239257 (WA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
401 W 13th St
Vancouver, WA 98660-2806
Phone: (319) 325-5579
Street-level locationGet directions
Mailing address
401 W 13th St
Vancouver, WA 98660-2806
Registry dates
- Enumerated
- 2015-04-06
- Last updated
- 2016-11-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.