Individual provider Active NPI

Bethany Joanne Erickson, MASSAGE THERAPIST

  • Massage Therapist
  • Puyallup, WA
National Provider Identifier
1164742706
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60146324 Issued in WA
Practice address
400 E Pioneer Ste 202
Puyallup, WA 98372-3257
Phone
(406) 531-3526
Fax
(253) 375-6688
NPI assigned
Jun 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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 MA60146324 WA Primary

Addresses

Primary practice location

400 E Pioneer Ste 202
Puyallup, WA 98372-3257

Mailing address

9215 219TH Street CT E
Graham, WA 98338-9290
Phone (406) 531-3526

Other practice location 1

13003 SE Kent Kangley Rd
Ste. 110
Kent, WA 98030-7919
Phone (253) 638-2424

Other practice location 2

12515 Meridian E Ste 205
Puyallup, WA 98373-3436
Phone (406) 531-3526

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
MA60146324WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Massage & Bodywork Massage Therapist Past Accepting new patients

Organizations & group practices 1

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": "1275696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1164742706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9215 219TH STREET CT E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983389290",
            "telephone_number": "406-531-3526",
            "fax_number": "253-375-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E PIONEER STE 202",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723257",
            "telephone_number": "406-531-3526",
            "fax_number": "253-375-6688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13003 SE Kent Kangley Rd",
            "address_2": "Ste. 110",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980307919",
            "country_code": "US",
            "telephone_number": "253-638-2424",
            "fax_number": "253-639-5115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12515 Meridian E Ste 205",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983733436",
            "country_code": "US",
            "telephone_number": "406-531-3526",
            "fax_number": "253-375-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "BETHANY",
        "middle_name": "JOANNE",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-05",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60146324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.