Peggy Ann Vittoria, LMP

Individual provider Active NPI Massage Therapist · Tenino, WA

NPI 1154584472 · NPPES record last updated Feb 11, 2016

Key facts

NPI
1154584472
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA00023756 (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
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA00023756WAMDMassage Therapist

Practice roles

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00023756 WA Yes

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

Other providers in Tenino, WA

All providers in Tenino, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.