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MS. LISA MARIE WICKLUND LMT
NPI 1609304476
Massage Therapist in Blaine, MN

Active since May 24, 2017
9140 BALTIMORE ST NE STE 140-5, BLAINE, MN 55449(612) 481-9718 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, May 24, 2017 (2 updates tracked since 2017).

About Ms. Lisa Marie Wicklund Lmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. LISA MARIE WICKLUND LMT (NPI 1609304476) is an individual massage therapist in Blaine, Minnesota, licensed in Minnesota (17-07455) and active in the NPI registry since May 2017.

NPPES Registry Identity

NPI1609304476
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameMS. LISA MARIE WICKLUNDCredential: LMT
Location Address9140 BALTIMORE ST NE STE 140-5Blaine, MN 55449-4382
Mailing Address9140 Baltimore St Ne Ste 140-5Blaine, MN 55449-4382 · (612) 481-9718
Phone(612) 481-9718
Sole ProprietorYes
Enumeration DateMay 24, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1609304476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in MN · 17-07455
Definition
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.
9140 BALTIMORE ST NE STE 140-5, Blaine, MN 55449
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Wicklund's NPI number?

The NPI number for Lisa Wicklund is 1609304476. It was assigned to this individual provider in the NPPES registry on May 24, 2017.

Where is Lisa Wicklund located?

Lisa Wicklund practices at 9140 Baltimore St NE Ste 140-5, Blaine, MN 55449. The listed phone number is (612) 481-9718.

What is Lisa Wicklund's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Lisa Wicklund was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.