Active NPI
Andrea Christine Whitehurst
- Massage Therapist
- Tacoma, WA
National Provider Identifier
1063760171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60262396
- Practice address
- 5631 Tacoma Mall Blvd
Tacoma, WA 98409-6921 - Phone
- (253) 682-0220
- NPI assigned
- Aug 21, 2012
- 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 | MA 60262396 | WA | Primary |
Addresses
Primary practice location
5631 Tacoma Mall Blvd
Tacoma, WA 98409-6921
Mailing address
7646 40TH St W. Apt 54
University Place, WA 98466
Phone (253) 341-9315
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 |
|---|---|---|---|
| MA 60262396 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379462400000",
"number": "1063760171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7646 40TH ST W. APT 54",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "98466",
"telephone_number": "253-341-9315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5631 TACOMA MALL BLVD",
"city": "TACOMA",
"state": "WA",
"postal_code": "984096921",
"telephone_number": "253-682-0220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHURST",
"first_name": "ANDREA",
"middle_name": "CHRISTINE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-21",
"last_updated": "2013-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60262396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.