Individual provider Active NPI

Andrea L Hopper

  • Massage Therapist
  • Port Orchard, WA
National Provider Identifier
1245622216
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60540936 Issued in WA
Practice address
871 Bethel Ave
Port Orchard, WA 98366-4229
Phone
(206) 795-6893
Fax
(360) 519-3777
NPI assigned
Feb 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227015146 IL
Massage Therapist 225700000X MA60540936 WA Primary

Addresses

Primary practice location

871 Bethel Ave
Port Orchard, WA 98366-4229

Mailing address

871 Bethel Ave
Port Orchard, WA 98366-4229
Phone (206) 795-6893

Other practice location 1

8939 Gravelly Lake Dr SW
Apt 6
Lakewood, WA 98499-3131
Phone (312) 256-7367

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

LicenseStateTypeSpecialty
227015146ILMDMassage Therapist
MA60540936WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1245622216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 BETHEL AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664229",
            "telephone_number": "206-795-6893",
            "fax_number": "360-519-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 BETHEL AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664229",
            "telephone_number": "206-795-6893",
            "fax_number": "360-519-3777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8939 Gravelly Lake Dr SW",
            "address_2": "Apt 6",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984993131",
            "country_code": "US",
            "telephone_number": "312-256-7367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOPPER",
        "first_name": "ANDREA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-26",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227015146",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60540936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.

Verify at the official NPI Registry.