Individual provider Active NPI

Dinel Rose Konrad, LMP

  • Massage Therapist
  • Puyallup, WA
National Provider Identifier
1467582601
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00009196 Issued in WA
Practice address
510 E Main Ste a
Puyallup, WA 98372-5612
Phone
(253) 841-4425
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00009196 WA Primary

Addresses

Primary practice location

510 E Main Ste a
Puyallup, WA 98372-5612

Mailing address

4602 N 42ND St
Tacoma, WA 98407-4921
Phone (253) 651-8302

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
MA00009196WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Church Massage Therapist Past Accepting new patients
Gregory Chiropractic 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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467582601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 N 42ND ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984074921",
            "telephone_number": "253-651-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E MAIN STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983725612",
            "telephone_number": "253-841-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONRAD",
        "first_name": "DINEL",
        "middle_name": "ROSE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00009196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, 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.

Verify at the official NPI Registry.