Mary Utton, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60138753 Issued in WA

Practice address

11600 SE Mill Plain Blvd
Ste 3J
Vancouver, WA 98684-5083

Phone

(360) 253-6674

Fax

(360) 253-8670

NPI assigned

Nov 5, 2010

Last updated

Nov 5, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael B. Pettet, DC, PS

  dba Back and Neck Care Chiropractic

  • Chiropractor
  • Vancouver, WA
  • NPI 1609086784

  Massage Therapist

  NPD (past)

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1336440411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4408 NE 151ST AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827115",
            "telephone_number": "360-253-6674",
            "fax_number": "360-253-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 SE MILL PLAIN BLVD",
            "address_2": "STE 3J",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845083",
            "telephone_number": "360-253-6674",
            "fax_number": "360-253-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTON",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60138753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.