Individual provider Active NPI

Peggy Ann Vittoria, LMP

  • Massage Therapist
  • Tenino, WA
National Provider Identifier
1154584472
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00023756 Issued in WA
Practice address
448 Sussex Ave E
#3
Tenino, WA 98589-8703
Phone
(360) 264-5999
Fax
(360) 264-5999
NPI assigned
Jul 7, 2008
Last updated
Feb 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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 MA00023756 WA Primary

Addresses

Primary practice location

448 Sussex Ave E
#3
Tenino, WA 98589-8703

Mailing address

PO Box 364
Tenino, WA 98589-0364
Phone (360) 561-0022

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
MA00023756WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Massage Therapy by Magic Inc Massage Therapist Past Accepting new patients
R & D Coulson Inc. Past Accepting new patients
Natural Wellness PLLC Past Accepting new patients

Organizations & group practices 3

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1154584472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985890364",
            "telephone_number": "360-561-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 SUSSEX AVE E",
            "address_2": "#3",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985898703",
            "telephone_number": "360-264-5999",
            "fax_number": "360-264-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITTORIA",
        "first_name": "PEGGY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tenino, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.