Active NPI
Vixai Nackviseth, LMP
- Massage Therapist
- Covington, WA
National Provider Identifier
1033423942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00019004
- Practice address
- 17307 SE 272ND St
Suite 126
Covington, WA 98042-5304 - Phone
- (253) 639-2266
- Fax
- (253) 639-8464
- NPI assigned
- Aug 3, 2010
- Sex
- Male
- Sole proprietor
- No
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 | MA00019004 | WA | Primary |
Addresses
Primary practice location
17307 SE 272ND St
Suite 126
Covington, WA 98042-5304
Mailing address
23925 225TH Way SE
Suite B
Maple Valley, WA 98038-5233
Phone (425) 433-0123
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 |
|---|---|---|---|
| MA00019004 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1033423942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23925 225TH WAY SE",
"address_2": "SUITE B",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980385233",
"telephone_number": "425-433-0123",
"fax_number": "425-433-0733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17307 SE 272ND ST",
"address_2": "SUITE 126",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980425304",
"telephone_number": "253-639-2266",
"fax_number": "253-639-8464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NACKVISETH",
"first_name": "VIXAI",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-03",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00019004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.