Provider Demographics
NPI:1033092945
Name:HILL, CALISA CHRISTINE (MA00011396)
Entity type:Individual
Prefix:MS
First Name:CALISA
Middle Name:CHRISTINE
Last Name:HILL
Suffix:
Gender:F
Credentials:MA00011396
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1594
Mailing Address - Street 2:
Mailing Address - City:OCEAN SHORES
Mailing Address - State:WA
Mailing Address - Zip Code:98569-1594
Mailing Address - Country:US
Mailing Address - Phone:360-591-5599
Mailing Address - Fax:
Practice Address - Street 1:114 E CHANCE A LA MER NE UNIT I
Practice Address - Street 2:
Practice Address - City:OCEAN SHORES
Practice Address - State:WA
Practice Address - Zip Code:98569-9202
Practice Address - Country:US
Practice Address - Phone:360-591-5599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011396225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist