Individual provider Active NPI

Lenora Burnett Pruzan, LMT

  • Massage Therapist
  • Auburn, WA
National Provider Identifier
1295389682
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60880135 Issued in WA
Practice address
4017 A St SE # B101
Auburn, WA 98002-8607
Phone
(253) 939-8144
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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 MA60880135 WA Primary

Addresses

Primary practice location

4017 A St SE # B101
Auburn, WA 98002-8607

Mailing address

125 Elise CT
Pacific, WA 98047-1204
Phone (425) 922-3935

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
MA60880135WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avise Chiropractic P L L C CurrentSince Jun 9, 2024 Accepting new patients

Locations

4017 A St SE
#B101
Auburn, WA 98002
Phone (253) 939-8144

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1295389682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ELISE CT",
            "city": "PACIFIC",
            "state": "WA",
            "postal_code": "980471204",
            "telephone_number": "425-922-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4017 A ST SE # B101",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980028607",
            "telephone_number": "253-939-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUZAN",
        "first_name": "LENORA",
        "middle_name": "BURNETT",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60880135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.