Active NPI
Dawn Joy Edgar, LMP
- Massage Therapist
- Vancouver, WA
National Provider Identifier
1306138417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60217498
- Practice address
- 5204 NE 131St Ave
Vancouver, WA 98682-2116 - Phone
- (503) 743-7228
- NPI assigned
- May 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA 60217498 | WA | |
| Massage Therapist | 225700000X | MA 60217498 | WA | Primary |
Addresses
Primary practice location
5204 NE 131St Ave
Vancouver, WA 98682-2116
Mailing address
5204 NE 131St Ave
Vancouver, WA 98682-2116
Phone (503) 743-7228
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA 60217498 | WA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304726400000",
"number": "1306138417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5204 NE 131ST AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986822116",
"telephone_number": "503-743-7228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5204 NE 131ST AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986822116",
"telephone_number": "503-743-7228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGAR",
"first_name": "DAWN",
"middle_name": "JOY",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-07",
"last_updated": "2011-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "WA",
"license": "MA 60217498",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60217498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.