Elton Ray Busby, LMP
Individual provider Active NPI Massage Therapist · Gig Harbor, WA
NPI 1184023988 · NPPES record last updated Dec 10, 2015
Key facts
- NPI
- 1184023988
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA60493610 (WA)
- Practice address
- 7700 Pioneer Way
Suite 101
Gig Harbor, WA 98335-1156 - Phone
- (253) 509-0258
- NPI assigned
- Aug 18, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60493610 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Moon Massage Studio, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60493610 | WA | Yes |
Addresses
Primary practice location
7700 Pioneer Way
Suite 101
Gig Harbor, WA 98335-1156
Mailing address
7700 Pioneer Way
Suite 101
Gig Harbor, WA 98335-1156
Phone (253) 509-0258
Other providers in Gig Harbor, WA
- Christy J Burdyshaw
- Burki Chiropractic Center, Inc., PS
- Burl Pettibon
- Shannon Burman
- Larissa Burton
- Tara Rose Buschor
- Burl Bert Buskirk Jr.
- Sarah Buskirk
- Lucas Christopher Butler
- Brittany Jean Buzard
All providers in Gig Harbor, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.