Individual provider Active NPI

Christopher Brandon Putrzenski, LMT

  • Massage Therapist
  • Richland, WA
National Provider Identifier
1417651118
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61361356 Issued in WA
Practice address
1776 Fowler St
Richland, WA 99352-4833
Phone
(509) 396-3980
NPI assigned
Mar 28, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 MA61361356 WA Primary

Addresses

Primary practice location

1776 Fowler St
Richland, WA 99352-4833

Mailing address

5216 Bakerloo LN
Pasco, WA 99301-6638
Phone (206) 380-6739

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
Credentials
Master of Theology

State licenses

LicenseStateTypeSpecialty
MA61361356WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Concepts, PLLC PastSince Jul 1, 2008 Accepting new patients
TRSR, PLLC Past Accepting new patients

Organizations & group practices 2

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": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1417651118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5216 BAKERLOO LN",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993016638",
            "telephone_number": "206-380-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 FOWLER ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524833",
            "telephone_number": "509-396-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTRZENSKI",
        "first_name": "CHRISTOPHER",
        "middle_name": "BRANDON",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61361356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.