Individual provider Active NPI

Patricia Fisher Ludemann, LMP

  • Massage Therapist
  • Puyallup, WA
National Provider Identifier
1295870517
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00021744 Issued in WA
Practice address
11713 101St Ave E
11713 101St Ave E
Puyallup, WA 98373
Phone
(253) 315-4206
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00021744 WA Primary

Addresses

Primary practice location

11713 101St Ave E
11713 101St Ave E
Puyallup, WA 98373

Mailing address

6314 Rebecca Ave SE
Auburn, WA 98092-8018
Phone (253) 315-4206

Other identifiers 1

IdentifierTypeStateIssuer
0207402OtherWAL&I PROVIDER ACCOUNT #

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
MA00021744WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295870517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6314 REBECCA AVE SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980928018",
            "telephone_number": "253-315-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11713 101ST AVE E",
            "address_2": "11713 101ST AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98373",
            "telephone_number": "253-315-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDEMANN",
        "first_name": "PATRICIA",
        "middle_name": "FISHER",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00021744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER ACCOUNT #",
            "identifier": "0207402",
            "state": "WA"
        }
    ],
    "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 Jul 8, 2007; 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.