Active NPI
Douglas Alan Leese, LMT
- Massage Therapist
- Omak, WA
National Provider Identifier
1588867246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00016504
- Practice address
- 616 Ironwood St
Omak, WA 98841-9545 - Phone
- (509) 429-8051
- NPI assigned
- Jun 8, 2007
- Sex
- Male
- 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 | MA00016504 | WA | Primary |
Addresses
Primary practice location
616 Ironwood St
Omak, WA 98841-9545
Mailing address
PO Box 4303
Omak, WA 98841-4303
Phone (509) 429-8051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 165116 | Other | WA | LABOR AND INDUSTRIES |
Other names 1
- Mr. Douglas A Leese
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 |
|---|---|---|---|
| MA00016504 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550102400000",
"number": "1588867246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4303",
"city": "OMAK",
"state": "WA",
"postal_code": "988414303",
"telephone_number": "509-429-8051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 IRONWOOD ST",
"city": "OMAK",
"state": "WA",
"postal_code": "988419545",
"telephone_number": "509-429-8051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEESE",
"first_name": "DOUGLAS",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-08",
"last_updated": "2019-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00016504",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "165116",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DOUGLAS",
"last_name": "LEESE",
"middle_name": "A",
"prefix": "MR.",
"credential": "MASSAGE LICENSE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Omak, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.