Dermavita Medispa

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

DERMAVITA MEDISPA

Practice address

11 Lake St
Kirkland, WA 98033-6111

Phone

(425) 739-0808

NPI assigned

Oct 1, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Magdalena Witwicki

Title

Owner

Phone

(425) 739-0808

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1003067646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LAKE ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336111",
            "telephone_number": "425-739-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 LAKE ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336111",
            "telephone_number": "425-739-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMAVITA MEDISPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "WITWICKI",
        "authorized_official_first_name": "MAGDALENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-739-0808"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Deputy Crofoot, LMP
• Briauna Maureen Depuy
• Thomas Gerald Depuydt, M.D.
• Shanti Nichelle Der Blatter
• Diana Dericks
• Dominic Desanto, DPT
• Jeremie M Descartes
• Muktai Abhay Deshpande, BDS, MS
• Briana Marie Desmet, PA-C
• Shannon M Devange, MS, CGC

• Massage Therapist in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.