Individual provider Active NPI

Michael Howard Tuttle, LMP

  • Massage Therapist
  • Everett, WA
National Provider Identifier
1336297852
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00019358 Issued in WA
Practice address
11419 19TH Ave SE
A-109
Everett, WA 98208-5120
Phone
(425) 379-2556
Fax
(425) 379-2585
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

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 MA00019358 WA Primary

Addresses

Primary practice location

11419 19TH Ave SE
A-109
Everett, WA 98208-5120

Mailing address

11419 19TH Ave SE
A-109
Everett, WA 98208-5120
Phone (425) 379-2556

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
MA00019358WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Milham Family Chiropractic, Inc PS PastSince Feb 12, 2016 Accepting new patients

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336297852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11419 19TH AVE SE",
            "address_2": "A-109",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085120",
            "telephone_number": "425-379-2556",
            "fax_number": "425-379-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11419 19TH AVE SE",
            "address_2": "A-109",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085120",
            "telephone_number": "425-379-2556",
            "fax_number": "425-379-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "MICHAEL",
        "middle_name": "HOWARD",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00019358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, 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.