Active NPI
Becky Waltz, LMP
- Specialist
- Edmonds, WA
National Provider Identifier
1194146647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA60407123
- Practice address
- 8401 Main St
Edmonds, WA 98026-6919 - Phone
- (425) 563-6893
- NPI assigned
- Dec 31, 2013
- Last updated
- Jan 6, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA60407123 | WI | Primary |
Addresses
Primary practice location
8401 Main St
Edmonds, WA 98026-6919
Mailing address
9889 Central Valley Rd NW
Bremerton, WA 98311-9131
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60407123 | WI | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Quest Chiropractic & Wellness Inc | Past | Accepting new patients | |
| Kitsap Practice Management, Inc. | Past | Accepting new patients | |
| Vision Quest Massage Management, Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba NW Therapeutic Massage & Wellness
- Massage Therapist
- Silverdale, WA
- NPI 1164725792
-
- Chiropractor
- Auburn, WA
- NPI 1063686541
-
- Massage Therapist
- Auburn, WA
- NPI 1881997419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388966400000",
"number": "1194146647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9889 CENTRAL VALLEY RD NW",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983119131",
"fax_number": "360-629-1718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 MAIN ST",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980266919",
"telephone_number": "425-563-6893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTZ",
"first_name": "BECKY",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-31",
"last_updated": "2014-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WI",
"license": "MA60407123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.