Active NPI
Marina V Shustov, LMT
- Massage Therapist
- Airway Heights, WA
National Provider Identifier
1306409925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 12727 W 14TH Ave
Airway Heights, WA 99001-9409 - Phone
- (509) 244-4818
- NPI assigned
- Apr 18, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary |
Addresses
Primary practice location
12727 W 14TH Ave
Airway Heights, WA 99001-9409
Mailing address
4909 E Upriver Dr Apt H104
Spokane, WA 99217-7269
Phone (509) 202-0740
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eric Dudenhofer Arnp PS | Single Specialty | Past | Accepting new patients |
| West Plains Chiropractic, PS | Single Specialty | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Mid River Skin Clinic
- Family Nurse Practitioner
- Clarkston, WA
- NPI 1245767631
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555545600000",
"number": "1306409925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4909 E UPRIVER DR APT H104",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992177269",
"telephone_number": "509-202-0740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12727 W 14TH AVE",
"city": "AIRWAY HEIGHTS",
"state": "WA",
"postal_code": "990019409",
"telephone_number": "509-244-4818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUSTOV",
"first_name": "MARINA",
"middle_name": "V",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-18",
"last_updated": "2019-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Airway Heights, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.