Individual provider Active NPI

Sang Chul Ko, LMP

  • Massage Therapist
  • Tacoma, WA
National Provider Identifier
1396016119
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60253959 Issued in WA
Practice address
8451 S D St
Tacoma, WA 98444-6450
Phone
(253) 389-9007
NPI assigned
Jan 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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 MA60253959 WA Primary

Addresses

Primary practice location

8451 S D St
Tacoma, WA 98444-6450

Mailing address

8451 S D St
Tacoma, WA 98444-6450
Phone (253) 389-9007

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
MA60253959WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1396016119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8451 S D ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984446450",
            "telephone_number": "253-389-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8451 S D ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984446450",
            "telephone_number": "253-389-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "SANG",
        "middle_name": "CHUL",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60253959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.