Carrie Deitz

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA 60708337 Issued in WA

Practice address

7104 265TH St NW Ste 130
Stanwood, WA 98292-6250

Phone

(206) 354-8382

NPI assigned

Dec 10, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carrie Derousse Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Decide Massage & Wellness

  • Health Maintenance Organization
  • Stanwood, WA
  • NPI 1013451079
  NPD (past)

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

{
    "created_epoch": "1481328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481328000000",
    "number": "1295279255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 SHORE AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982031228",
            "telephone_number": "206-354-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7104 265TH ST NW STE 130",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926250",
            "telephone_number": "206-354-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITZ",
        "first_name": "CARRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-10",
        "last_updated": "2016-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60708337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "DEROUSSE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher S Davis, LMHC
• Rachael Anne Davis, LMP
• Taylor Alane Dawn, PA-C
• Daniel J Day, MPT
• Decide Massage & Wellness
• Dental Professionals of Washington, Quirt, Mongrain, Gibree, PC
• Elizabeth Dominguez, PA-C
• Melisa Donnelly, M.A., SLP-CF
• Doorway of Hope Ministries
• Leonard David Dubay, DDS

• Massage Therapist in Stanwood, WA
• Providers in Stanwood, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2016; 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.