Individual provider Active NPI

Tommie Mitchel Doran, LMT

  • Massage Therapist
  • Poulsbo, WA
National Provider Identifier
1427461458
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60494697 Issued in WA
Practice address
25233 Pioneer Way NW
Poulsbo, WA 98370-9553
Phone
(360) 865-1160
NPI assigned
Jun 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60494697 WA Primary
Mechanotherapist 172M00000X MA60494697 WA

Addresses

Primary practice location

25233 Pioneer Way NW
Poulsbo, WA 98370-9553

Mailing address

25233 Pioneer Way NW
Poulsbo, WA 98370-9553
Phone (360) 865-1160

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
MA60494697WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1427461458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25233 PIONEER WAY NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709553",
            "telephone_number": "360-865-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25233 PIONEER WAY NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709553",
            "telephone_number": "360-865-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "TOMMIE",
        "middle_name": "MITCHEL",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-06",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60494697",
            "primary": true
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "WA",
            "license": "MA60494697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.