Individual provider Active NPI

Ladonna Marie Massar, LMP

  • Massage Therapist
  • Port Orchard, WA
National Provider Identifier
1043343643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00023399 Issued in WA
Practice address
2475 Bethel Rd SE
Suite 102
Port Orchard, WA 98366-2490
Phone
(360) 895-4844
Fax
(360) 895-4834
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00023399 WA Primary

Addresses

Primary practice location

2475 Bethel Rd SE
Suite 102
Port Orchard, WA 98366-2490

Mailing address

2730 Harbor Heights LN E
Port Orchard, WA 98366-8104
Phone (360) 871-6257

Other identifiers 1

IdentifierTypeStateIssuer
216552OtherWAL&I NUMBER

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
MA00023399WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043343643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 HARBOR HEIGHTS LN E",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983668104",
            "telephone_number": "360-871-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 BETHEL RD SE",
            "address_2": "SUITE 102",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662490",
            "telephone_number": "360-895-4844",
            "fax_number": "360-895-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSAR",
        "first_name": "LADONNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER",
            "identifier": "216552",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.