Individual provider Active NPI

Robby Eldenburg

  • Massage Therapist
  • Spokane, WA
National Provider Identifier
1578860045
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
603063637 Issued in WA
Practice address
430 W 2ND Ave
Spokane, WA 99201-6003
Phone
(509) 999-4523
NPI assigned
Feb 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 603063637 WA Primary

Addresses

Primary practice location

430 W 2ND Ave
Spokane, WA 99201-6003

Mailing address

3122 W 6TH Ave
Spokane, WA 99224-1823

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
603063637WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1578860045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 W 6TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992241823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W 2ND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992016003",
            "telephone_number": "509-999-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDENBURG",
        "first_name": "ROBBY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "603063637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.