Individual provider Active NPI

Miranda Levonne Thaemert, LMP

  • Massage Therapist
  • Silverdale, WA
National Provider Identifier
1033345384
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60036699 Issued in WA
Practice address
3073 NW Bucklin Hill Rd
Silverdale, WA 98383-9190
Phone
(360) 551-9990
Fax
(360) 692-0932
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60036699 WA Primary

Addresses

Primary practice location

3073 NW Bucklin Hill Rd
Silverdale, WA 98383-9190

Mailing address

3073 NW Bucklin Hill Rd
Silverdale, WA 98383-9190
Phone (360) 551-9990

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

LicenseStateTypeSpecialty
MA60036699WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1033345384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 NW BUCKLIN HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839190",
            "telephone_number": "360-551-9990",
            "fax_number": "360-692-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 NW BUCKLIN HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839190",
            "telephone_number": "360-551-9990",
            "fax_number": "360-692-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAEMERT",
        "first_name": "MIRANDA",
        "middle_name": "LEVONNE",
        "name_prefix": "Miss",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60036699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.