Active NPI
Robert C Hackett, BA, LMP
- Massage Therapist
- Bonney Lake, WA
National Provider Identifier
1295023109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- HACKERC434RP
- Practice address
- 18209 Sr 410 E Ste 100
Bonney Lake, WA 98391-5146 - Phone
- (253) 826-5500
- NPI assigned
- Jul 12, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | HACKERC434RP | WA | Primary |
Addresses
Primary practice location
18209 Sr 410 E Ste 100
Bonney Lake, WA 98391-5146
Mailing address
730 Gravity Way
Buckley, WA 98321-9425
Phone (253) 709-8971
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HACKERC434RP | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310428800000",
"number": "1295023109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 GRAVITY WAY",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "983219425",
"telephone_number": "253-709-8971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18209 SR 410 E STE 100",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983915146",
"telephone_number": "253-826-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKETT",
"first_name": "ROBERT",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "BA, LMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-12",
"last_updated": "2011-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "HACKERC434RP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.