Active NPI
Demetrio Arsenio Jose, LMP
- Massage Therapist
- Edmonds, WA
National Provider Identifier
1447341334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00009412
- Practice address
- 21009 76TH Ave W
Edmonds, WA 98026-7126 - Phone
- (425) 670-2910
- Fax
- (425) 778-1872
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00009412 | WA | Primary |
Addresses
Primary practice location
21009 76TH Ave W
Edmonds, WA 98026-7126
Mailing address
22323 58TH Ave W
Mountlake Terrace, WA 98043-3825
Phone (425) 673-9874
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00009412 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axis Physical Therapy Inc | Past | Accepting new patients | |
| Martha Lake Physical Therapy Inc | 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.
-
- Physical Therapist
- Edmonds, WA
- NPI 1205864816
-
- Physical Therapist
- Lynnwood, WA
- NPI 1104265412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447341334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22323 58TH AVE W",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980433825",
"telephone_number": "425-673-9874",
"fax_number": "425-778-1872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21009 76TH AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267126",
"telephone_number": "425-670-2910",
"fax_number": "425-778-1872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSE",
"first_name": "DEMETRIO",
"middle_name": "ARSENIO",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00009412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.