Active NPI
Sara Jean Denherder, LMP
- Massage Therapist
- Renton, WA
National Provider Identifier
1023173465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00018219
- Practice address
- 17070 - 140TH Ave SE
Renton, WA 98058 - Phone
- (206) 228-6296
- Fax
- (425) 277-2931
- NPI assigned
- Dec 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00018219 | WA | Primary |
Addresses
Primary practice location
17070 - 140TH Ave SE
Renton, WA 98058
Mailing address
18635 - 175 Avenue SE
Renton, WA 98058-9539
Phone (206) 228-6296
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0175957 | Other | WA | DEPARTMENT OF L&I |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00018219 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202428800000",
"number": "1023173465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18635 - 175 AVENUE SE",
"city": "RENTON",
"state": "WA",
"postal_code": "980589539",
"telephone_number": "206-228-6296",
"fax_number": "425-277-2931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17070 - 140TH AVE SE",
"city": "RENTON",
"state": "WA",
"postal_code": "98058",
"telephone_number": "206-228-6296",
"fax_number": "425-277-2931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENHERDER",
"first_name": "SARA",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2008-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00018219",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF L&I",
"identifier": "0175957",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.