Individual provider Active NPI

Deanna Kay Blevins, LMP, CR

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1568601995
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00023072 Issued in WA
Practice address
2917 Washington St
Suite 104
Vancouver, WA 98660-2258
Phone
(360) 609-8707
NPI assigned
Feb 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00023072 WA Primary
Reflexologist 173C00000X CERTIFIED WA

Addresses

Primary practice location

2917 Washington St
Suite 104
Vancouver, WA 98660-2258

Mailing address

409 W 25TH St
Vancouver, WA 98660-2547
Phone (360) 609-8707

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
CERTIFIEDWAMDReflexologist
MA00023072WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1568601995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W 25TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602547",
            "telephone_number": "360-609-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 WASHINGTON ST",
            "address_2": "SUITE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602258",
            "telephone_number": "360-609-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "DEANNA",
        "middle_name": "KAY",
        "credential": "LMP, CR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023072",
            "primary": true
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "WA",
            "license": "CERTIFIED",
            "primary": false
        }
    ],
    "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 Jul 25, 2014; 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.