NPIMap

Individual provider Active NPI

Casey L Moffett, LMP

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1457538068
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00019971 Issued in WA
Practice address
11600 SE Mill Plain Blvd
Suite 3J
Vancouver, WA 98684-5083
Phone
(360) 253-6674
Fax
(360) 253-8670
NPI assigned
Jan 25, 2008
Last updated
Oct 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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 MA00019971 WA Primary

Addresses

Primary practice location

11600 SE Mill Plain Blvd
Suite 3J
Vancouver, WA 98684-5083

Mailing address

11600 SE Mill Plain Blvd
Suite 3J
Vancouver, WA 98684-5083
Phone (360) 253-6674

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
MA00019971WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael B. Pettet, DC, PS Massage Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1457538068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 SE MILL PLAIN BLVD",
            "address_2": "SUITE 3J",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845083",
            "telephone_number": "360-253-6674",
            "fax_number": "360-253-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 SE MILL PLAIN BLVD",
            "address_2": "SUITE 3J",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845083",
            "telephone_number": "360-253-6674",
            "fax_number": "360-253-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "CASEY",
        "middle_name": "L",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00019971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.