Active NPI
Izabella Domenique Perez Martinez, LMT
- Massage Therapist
- Kennewick, WA
National Provider Identifier
1578270963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA61316361
- Practice address
- 333 W Canal Dr
Kennewick, WA 99336-3845 - Phone
- (509) 572-1213
- NPI assigned
- Nov 3, 2022
- Last updated
- Nov 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | MA61316361 | WA | Primary |
Addresses
Primary practice location
333 W Canal Dr
Kennewick, WA 99336-3845
Mailing address
109 N Ione St
Kennewick, WA 99336-3556
Phone (509) 572-1213
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
- Credentials
- Master of Theology
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA61316361 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forsberg Chiropractic Clinic, P.S. | Past | Accepting new patients | |
| Garberg Chiropractic PLLC | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Richland, WA
- NPI 1770785453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667433600000",
"number": "1578270963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 N IONE ST",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993363556",
"telephone_number": "509-572-1213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 W CANAL DR",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993363845",
"telephone_number": "509-572-1213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ MARTINEZ",
"first_name": "IZABELLA",
"middle_name": "DOMENIQUE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-03",
"last_updated": "2022-11-03",
"certification_date": "2022-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA61316361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.