Active NPI
Latisha Marie Gent, MA60898240
- Massage Therapist
- Renton, WA
National Provider Identifier
1578027330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60898240
- Practice address
- 200 S Tobin St Ste a
Renton, WA 98057-5338 - Phone
- (425) 243-7705
- Fax
- (425) 321-5508
- NPI assigned
- Jan 25, 2019
- Sex
- Female
- 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 | MA60898240 | WA | Primary |
Addresses
Primary practice location
200 S Tobin St Ste a
Renton, WA 98057-5338
Mailing address
28413 22ND Ave S
Federal Way, WA 98003-3237
Phone (253) 961-6569
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 |
|---|---|---|---|
| MA60898240 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618012800000",
"number": "1578027330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28413 22ND AVE S",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980033237",
"telephone_number": "253-961-6569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S TOBIN ST STE A",
"city": "RENTON",
"state": "WA",
"postal_code": "980575338",
"telephone_number": "425-243-7705",
"fax_number": "425-321-5508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENT",
"first_name": "LATISHA",
"middle_name": "MARIE",
"credential": "MA60898240",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-25",
"last_updated": "2021-04-10",
"certification_date": "2021-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60898240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.