Individual provider Active NPI

Mary Ann Tahkeal, LMP, CNMT

  • Massage Therapist
  • Yakima, WA
National Provider Identifier
1467754804
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 60260772 Issued in WA
Practice address
915 Summitview Ave
Yakima, WA 98902-3021
Phone
(509) 469-1903
NPI assigned
Nov 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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 MA 60260772 WA Primary

Addresses

Primary practice location

915 Summitview Ave
Yakima, WA 98902-3021

Mailing address

7610 W Nob Hill Blvd
Unit # 117
Yakima, WA 98908-1957
Phone (509) 594-0325

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
MA 60260772WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body Pro Clinic, Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1467754804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 W NOB HILL BLVD",
            "address_2": "UNIT # 117",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989081957",
            "telephone_number": "509-594-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023021",
            "telephone_number": "509-469-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHKEAL",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "LMP, CNMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60260772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.