NPIMap

Organization Active NPI

Phoenixbody Works

  • Mechanotherapist
  • Puyallup, WA
National Provider Identifier
1306242417
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
MA00020960 Issued in WA
Legal business name
PHOENIXBODY WORKS
Practice address
12815 Canyon Rd E Ste I
Puyallup, WA 98373-5104
Phone
(253) 880-7447
NPI assigned
Nov 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Authorized official

Name
Miss Jennifer Diana Ortiz, MA00020960
Title
LMP
Phone
(253) 880-7447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MechanotherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 172M00000X MA00020960 WA Primary

Addresses

Primary practice location

12815 Canyon Rd E Ste I
Puyallup, WA 98373-5104

Mailing address

12815 Canyon Rd E Ste I
Puyallup, WA 98373-5104
Phone (253) 880-7447

National Provider Directory

National Provider Directory

Locations

12815 Canyon Rd E
Ste I
Puyallup, WA 98373
Phone (253) 256-4769

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1306242417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12815 CANYON RD E STE I",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735104",
            "telephone_number": "253-880-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 CANYON RD E STE I",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735104",
            "telephone_number": "253-880-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIXBODY WORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-17",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "DIANA",
        "authorized_official_title_or_position": "LMP",
        "authorized_official_telephone_number": "253-880-7447",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MA00020960"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Mechanotherapist",
            "state": "WA",
            "license": "MA00020960",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 17, 2014; 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.