Rebecca Pavack, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA 60237541 Issued in WA

Practice address

103 E Main Ave
Chewelah, WA 99109-8960

Phone

(509) 935-2225

Fax

(509) 935-2273

NPI assigned

Feb 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Champion Family Chiropractic,

  • Chiropractor
  • Chewelah, WA
  • NPI 1427045566
  NPD (past)

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1134544620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E MAIN AVE",
            "address_2": "PO BOX 203",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991098960",
            "telephone_number": "509-935-2225",
            "fax_number": "509-935-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E MAIN AVE",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991098960",
            "telephone_number": "509-935-2225",
            "fax_number": "509-935-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVACK",
        "first_name": "REBECCA",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60237541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPT OF HEALTH",
            "identifier": "MA 60237541",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna Dawn Norvell, MS LMHC
• Options for Opportunity
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• Michael S Patterson, PAC
• Nikole Emma Paul, R.D.H.
• David A Peck, ARNP
• Dustin Daniel Person, PHARMD
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• Providence Health & Services

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.