Philip Middle Daugherty, LMT/LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60267132 Issued in WA

Practice address

10513 Silverdale Way NW Ste 102
Silverdale, WA 98383-9499

Phone

(360) 698-4411

Fax

(360) 698-6953

NPI assigned

Jul 14, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Advanced Wellness & Rehabilitation PLLC

  • Chiropractor
  • Silverdale, WA
  • NPI 1700390267
  NPD (past)
• Advanced Wellness and Rehabilitation PLLC

  • Chiropractor
  • Silverdale, WA
  • NPI 1932460896
  NPD (past)

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1194132993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 CAMPBELL WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103380",
            "telephone_number": "360-710-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10513 SILVERDALE WAY NW STE 102",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839499",
            "telephone_number": "360-698-4411",
            "fax_number": "360-698-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "PHILIP",
        "middle_name": "MIDDLE",
        "credential": "LMT/LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60267132",
            "primary": true
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "WA",
            "license": "MA60267132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David C. Houpt D.M.D.
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• Jennifer Davide
• Lisa Ann Davidson, CPNP
• Andrew Davies

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.