Active NPI
Melandro M Gile, LMT
- Massage Therapist
- Kent, WA
National Provider Identifier
1477739746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00023507
- Practice address
- 25012 104TH Ave SE
Ste C
Kent, WA 98030-2821 - Phone
- (253) 840-2313
- Fax
- (253) 840-6340
- NPI assigned
- Jan 16, 2008
- 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 | MA00023507 | WA | Primary |
Addresses
Primary practice location
25012 104TH Ave SE
Ste C
Kent, WA 98030-2821
Mailing address
PO Box 731269
Puyallup, WA 98373-0060
Phone (253) 840-2313
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 |
|---|---|---|---|
| MA00023507 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200441600000",
"number": "1477739746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 731269",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983730060",
"telephone_number": "253-840-2313",
"fax_number": "253-840-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25012 104TH AVE SE",
"address_2": "STE C",
"city": "KENT",
"state": "WA",
"postal_code": "980302821",
"telephone_number": "253-840-2313",
"fax_number": "253-840-6340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILE",
"first_name": "MELANDRO",
"middle_name": "M",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-16",
"last_updated": "2008-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00023507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.