Individual provider Active NPI

Andrea Marie Gance, LMT

  • Massage Therapist
  • University Place, WA
National Provider Identifier
1407485659
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA.61007023 Issued in WA
Practice address
3102 Bridgeport Way W
University Place, WA 98466-4525
Phone
(253) 565-0476
NPI assigned
Apr 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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 MA.61007023 WA Primary

Addresses

Primary practice location

3102 Bridgeport Way W
University Place, WA 98466-4525

Mailing address

21803 42ND Ave E
Spanaway, WA 98387-6870
Phone (253) 476-0377

Other practice location 1

8615 S Tacoma Way
Tacoma, WA 98499-4542
Phone (253) 588-3355

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
MA.61007023WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympus Spa Massage Therapist Past Accepting new patients
Family Practice of Chiropractic Inc. P.S. PastSince Apr 17, 2020 Accepting new patients
Olympus Spa Inc Past Accepting new patients

Organizations & group practices 3

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": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1407485659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21803 42ND AVE E",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983876870",
            "telephone_number": "253-476-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664525",
            "telephone_number": "253-565-0476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8615 S Tacoma Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984994542",
            "country_code": "US",
            "telephone_number": "253-588-3355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANCE",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA.61007023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.

Verify at the official NPI Registry.