Dale G Wanden, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00024926 Issued in WA

Practice address

1140 140TH Ave NE Ste a
Bellevue, WA 98005-2975

Phone

(425) 957-0761

Fax

(425) 957-1156

NPI assigned

Oct 22, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1497907364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 RYAN AVE",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983901428",
            "telephone_number": "253-282-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 140TH AVE NE STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052975",
            "telephone_number": "425-957-0761",
            "fax_number": "425-957-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDEN",
        "first_name": "DALE",
        "middle_name": "G",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Walters
• Richard C. Walters, M.A.
• Scott William Walters, M.A., LMHCA
• Sydney Ann Walters, DMD
• Daisy Y Wan, RD
• Anni Wang, BCBA
• Audrey Jeannette Wang, M.D.
• Bennet M. Wang, M.D.
• Bowen Wang
• Charles R Wang, MD

• Massage Therapist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.