Individual provider Active NPI

Christopher Aaron Pengel

  • Massage Therapist
  • Tacoma, WA
National Provider Identifier
1174033153
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60626686 Issued in WA
Practice address
1310 S Union Ave Ste A202
Tacoma, WA 98405-1907
Phone
(253) 507-4631
Fax
(253) 507-4631
NPI assigned
Oct 4, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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 MA60626686 WA Primary

Addresses

Primary practice location

1310 S Union Ave Ste A202
Tacoma, WA 98405-1907

Mailing address

1310 S Union Ave Ste A202
Tacoma, WA 98405-1907
Phone (253) 507-4631

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
MA60626686WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Chiropractic & Massage LLC 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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1174033153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 S UNION AVE STE A202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051907",
            "telephone_number": "253-507-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 S UNION AVE STE A202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051907",
            "telephone_number": "253-507-4631",
            "fax_number": "253-507-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENGEL",
        "first_name": "CHRISTOPHER",
        "middle_name": "AARON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60626686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.