Individual provider Active NPI

Deborah Utterback

  • Massage Therapist
  • Tacoma, WA
National Provider Identifier
1114356524
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 60388783 Issued in WA
Practice address
7910 Pacific Ave
Tacoma, WA 98408-7031
Phone
(253) 473-3733
Fax
(253) 473-9517
NPI assigned
Nov 6, 2013
Last updated
Nov 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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 MA 60388783 WA Primary

Addresses

Primary practice location

7910 Pacific Ave
Tacoma, WA 98408-7031

Mailing address

7434 S Warner St
Tacoma, WA 98409-3924

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
MA 60388783WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tacoma Wellness Center, PLLC PastSince Jul 27, 2015 Accepting new patients
Active Chiropractic Clinic PS Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1114356524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7434 S WARNER ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984093924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087031",
            "telephone_number": "253-473-3733",
            "fax_number": "253-473-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTERBACK",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60388783",
            "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 Nov 6, 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.

Verify at the official NPI Registry.