Active NPI
Andrea Moore, LMT
- Massage Therapist
- Spokane Valley, WA
National Provider Identifier
1356991764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60968028
- Practice address
- 12308 E Broadway Ave Ste 4
Spokane Valley, WA 99216-2920 - Phone
- (509) 795-0165
- NPI assigned
- Sep 17, 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 | MA60968028 | WA | Primary |
Addresses
Primary practice location
12308 E Broadway Ave Ste 4
Spokane Valley, WA 99216-2920
Mailing address
PO Box 1082
Spokane, WA 99210-1082
Phone (509) 795-0165
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 |
|---|---|---|---|
| MA60968028 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raab Chiropractic, LLC | Past | 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": "1568678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1356991764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1082",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992101082",
"telephone_number": "509-795-0165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12308 E BROADWAY AVE STE 4",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992162920",
"telephone_number": "509-795-0165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ANDREA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-17",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60968028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.