Individual provider Active NPI

Lee Kim Tieu I, LMP

  • Massage Therapist
  • Puyallup, WA
National Provider Identifier
1245695741
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60475807 Issued in WA
Practice address
9909 168TH St E
Suite 102
Puyallup, WA 98375-2513
Phone
(253) 445-3000
NPI assigned
Dec 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60475807 WA Primary

Addresses

Primary practice location

9909 168TH St E
Suite 102
Puyallup, WA 98375-2513

Mailing address

9909 168TH St E
Suite 102
Puyallup, WA 98375-2513
Phone (253) 445-3000

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
MA60475807WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1245695741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 168TH ST E",
            "address_2": "SUITE 102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752513",
            "telephone_number": "253-445-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 168TH ST E",
            "address_2": "SUITE 102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752513",
            "telephone_number": "253-445-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEU",
        "first_name": "LEE",
        "middle_name": "KIM",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60475807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.