Individual provider Active NPI

Michael Paul Frietze, LMT, NAC

  • Massage Therapist
  • Chehalis, WA
National Provider Identifier
1073114815
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61107184 Issued in WA
Practice address
519 SW Cascade Ave
Chehalis, WA 98532-3213
Phone
(360) 269-4919
NPI assigned
Nov 6, 2020
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 MA61107184 WA Primary

Addresses

Primary practice location

519 SW Cascade Ave
Chehalis, WA 98532-3213

Mailing address

519 SW Cascade Ave
Chehalis, WA 98532-3213
Phone (360) 269-4919

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
MA61107184WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1073114815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 SW CASCADE AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323213",
            "telephone_number": "360-269-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 SW CASCADE AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323213",
            "telephone_number": "360-269-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIETZE",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LMT, NAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61107184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.