Active NPI
Courtney Janelle Madlung, L.M.P.
- Massage Therapist
- Sumner, WA
National Provider Identifier
1043385438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00019055
- Practice address
- 15324 Main St E Ste B
Sumner, WA 98390-2698 - Phone
- (253) 863-5323
- Fax
- (253) 863-2034
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- 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 | MA00019055 | WA | Primary |
Addresses
Primary practice location
15324 Main St E Ste B
Sumner, WA 98390-2698
Mailing address
15324 Main St E Ste B
Sumner, WA 98390-2698
Phone (253) 863-5323
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91-1580839 | Other | WA | GROUP TAX ID# |
| 602414363 | Other | WA | TAX ID# |
| MA00019055 | Other | WA | WA LICENSE CREDENTIAL# |
| 183864 | Other | WA | INT'L MASSAGE ASSOC# |
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 |
|---|---|---|---|
| MA00019055 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043385438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15324 MAIN ST E STE B",
"city": "SUMNER",
"state": "WA",
"postal_code": "983902698",
"telephone_number": "253-863-5323",
"fax_number": "253-863-2034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15324 MAIN ST E STE B",
"city": "SUMNER",
"state": "WA",
"postal_code": "983902698",
"telephone_number": "253-863-5323",
"fax_number": "253-863-2034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADLUNG",
"first_name": "COURTNEY",
"middle_name": "JANELLE",
"name_prefix": "Mrs.",
"credential": "L.M.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00019055",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP TAX ID#",
"identifier": "91-1580839",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID#",
"identifier": "602414363",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA LICENSE CREDENTIAL#",
"identifier": "MA00019055",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INT'L MASSAGE ASSOC#",
"identifier": "183864",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sumner, 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.