Logan Tyler Camacho

Individual provider Active NPI Massage Therapist · Zillah, WA

NPI 1023976552 · NPPES record last updated Jan 13, 2026

Key facts

NPI
1023976552
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA70069288 (WA)
Practice address
607 1St Ave
Zillah, WA 98953-9433
Phone
(509) 829-5757
Fax
(509) 829-5051
NPI assigned
Jan 13, 2026
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA70069288WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Delp Chiropractic Past
since Apr 25, 2014
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA70069288 WA Yes

Addresses

Primary practice location

607 1St Ave
Zillah, WA 98953-9433

Mailing address

PO Box 504
Zillah, WA 98953-0504

Other providers in Zillah, WA

All providers in Zillah, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.