Individual provider Active NPI

Casey Johanson

  • Massage Therapist
  • Wenatchee, WA
National Provider Identifier
1588064307
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60481288 Issued in WA
Practice address
2623 Euclid Ave
Wenatchee, WA 98801-3596
Phone
(509) 664-7081
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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 MA60481288 WA Primary

Addresses

Primary practice location

2623 Euclid Ave
Wenatchee, WA 98801-3596

Mailing address

725 Vista View PL
East Wenatchee, WA 98802-4048
Phone (509) 264-3957

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
MA60481288WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1588064307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 VISTA VIEW PL",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988024048",
            "telephone_number": "509-264-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 EUCLID AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013596",
            "telephone_number": "509-664-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSON",
        "first_name": "CASEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60481288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.