Northwest Sports Performance

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

NORTHWEST SPORTS PERFORMANCE

Practice address

15916 93Rd Ave E
Puyallup, WA 98375-6718

Phone

(206) 383-3186

NPI assigned

Aug 16, 2021

Organization subpart

No

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

Authorized official

Name

Kevin Vandenbosch, LMT

Title

LMT

Phone

(206) 383-3186

Specialties & licenses 1

Addresses

Tax ID family

Northwest Sports Performance2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northwest Sports Performance

  • Sports Physical Therapist
  • Tacoma, WA
  • NPI 1356024228
  NPD tax ID

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1134894652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15916 93RD AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756718",
            "telephone_number": "206-383-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15916 93RD AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756718",
            "telephone_number": "206-383-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SPORTS PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "VANDENBOSCH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "LMT",
        "authorized_official_telephone_number": "206-383-3186",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Mark Norris, R.PH.
• Northwest Family Chiropractic PC
• Northwest Foot and Ankle Center, PS
• Northwest Medical Specialties, PLLC
• Northwest Mental Health Net
• Greg Charles Norton
• Jason Notario, DMD
• Keali Nowak, LMFTA
• Emily Jean Nugen, MOTR/L
• Angela Marie Nugent, MA

• Massage Therapist in Puyallup, WA
• Providers in Puyallup, 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 16, 2021; 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.