Brian B Bacungan, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA 60320042 Issued in WA

Practice address

2208 NW Market St
430B
Seattle, WA 98107-4030

Phone

(808) 232-8098

NPI assigned

Jan 19, 2013

Last updated

Aug 31, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1124366596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15433 COUNTRY CLUB DR",
            "address_2": "A103",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121260",
            "telephone_number": "808-232-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 NW MARKET ST",
            "address_2": "430B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074030",
            "telephone_number": "808-232-8098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACUNGAN",
        "first_name": "BRIAN",
        "middle_name": "B",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-19",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60320042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark L Backus, M.D.
• Brittany Seabury Bacon, M.A.
• Erica Renee Bacon
• Stacy Bacon
• David John Bacsik
• Nicolas Awad Baddour, MD
• Thomas Anthony Bade, MA, AAC
• Harris P Baden
• Haley J Bader, MA
• Amy Badger, LMP

• Massage Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.