Mueanfan Suttipui

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61162304 Issued in WA

Practice address

7207 265TH St NW Ste 102
Stanwood, WA 98292-6274

Phone

(360) 629-6544

Fax

(360) 629-4520

NPI assigned

Aug 26, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: village@whidbey.net

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.

• Village Chiropractic Clinic LLC

  • Chiropractor
  • Stanwood, WA
  • NPI 1689185217
  NPD

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1417624404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 FALCON RD",
            "city": "CAMANO ISLAND",
            "state": "WA",
            "postal_code": "982828411",
            "telephone_number": "425-220-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7207 265TH ST NW STE 102",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926274",
            "telephone_number": "360-629-6544",
            "fax_number": "360-629-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTIPUI",
        "first_name": "MUEANFAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61162304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Village@Whidbey.net",
            "affiliation": "N",
            "endpointDescription": "Secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7207 265th St NW Ste 102",
            "city": "Stanwood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982926274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maurice Stinn, PHARMACIST
• Melissa Kimberly Stork, CD
• Revallee Ann Suffern-Osburn, L.M.P.
• Kaia Marie Summerfield
• Sunrise Services, Inc.
• Richard D Swetman, DC
• Connie Tamura, PHD
• Grant E Taylor, MD
• Telecare Mental Health Services of Washington, Inc (Telecare Fern Lodge Behavioral Wellness)
• Danielle Suzette Thayer, LMFTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.