Active NPI
Gary James Wartella II, LMT
- Massage Therapist
- Vancouver, WA
National Provider Identifier
1205469871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 60909358
- Practice address
- 21201 NE 58TH St Unit 1
Vancouver, WA 98682-9660 - Phone
- (254) 661-9089
- NPI assigned
- Feb 21, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 24737 | OR | |
| Massage Therapist | 225700000X | 60909358 | WA | Primary |
Addresses
Primary practice location
21201 NE 58TH St Unit 1
Vancouver, WA 98682-9660
Mailing address
21201 NE 58TH St Unit 1
Vancouver, WA 98682-9660
Phone (254) 661-9089
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 |
|---|---|---|---|
| 24737 | OR | MD | Massage Therapist |
| 60909358 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1205469871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21201 NE 58TH ST UNIT 1",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986829660",
"telephone_number": "254-661-9089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21201 NE 58TH ST UNIT 1",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986829660",
"telephone_number": "254-661-9089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARTELLA",
"first_name": "GARY",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-21",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "24737",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "WA",
"license": "60909358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.