Melissa Ann Fulfer, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00023942 Issued in WA

Practice address

12704 Mukilteo Speedway Ste C
Mukilteo, WA 98275-5720

Phone

(425) 290-1919

Fax

(425) 353-9690

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Van Driessche Chiropractic P S

  • Preferred Provider Organization
  • Mukilteo, WA
  • NPI 1184884108
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186099200000",
    "number": "1174733315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 W CASINO RD APT 2",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982048165",
            "telephone_number": "425-322-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12704 MUKILTEO SPEEDWAY STE C",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755720",
            "telephone_number": "425-290-1919",
            "fax_number": "425-353-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULFER",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Mukilteo, WA
• Providers in Mukilteo, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2007; 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.