NPIMap

Individual provider Active NPI

Brandon Cruz, LMP

  • Massage Therapist
  • Auburn, WA
National Provider Identifier
1154734457
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60416547 Issued in WA
Practice address
1118 Outlet Collection Dr SW
Suite 101
Auburn, WA 98001-6569
Phone
(253) 269-0261
Fax
(253) 269-0202
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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 MA60416547 WA Primary

Addresses

Primary practice location

1118 Outlet Collection Dr SW
Suite 101
Auburn, WA 98001-6569

Mailing address

9889 Central Valley Rd NW
Bremerton, WA 98311-9131
Phone (360) 692-7321

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
MA60416547WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Practice Management, Inc. Massage Therapist Past Accepting new patients
Vision Quest Massage Management, Inc Massage Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1154734457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9889 CENTRAL VALLEY RD NW",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983119131",
            "telephone_number": "360-692-7321",
            "fax_number": "360-692-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 OUTLET COLLECTION DR SW",
            "address_2": "SUITE 101",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980016569",
            "telephone_number": "253-269-0261",
            "fax_number": "253-269-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "BRANDON",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60416547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.