NPIMap

Organization Active NPI

Northwest Therapeutic Massage

  • Specialist
  • University Place, WA
National Provider Identifier
1619365830
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
60401382 Issued in WA
Legal business name
NORTHWEST THERAPEUTIC MASSAGE
Practice address
4113 Bridgeport Way W Ste B
University Place, WA 98466-4325
Phone
(253) 564-5828
Fax
(253) 564-0115
NPI assigned
Dec 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Mr. Bruce Corns
Title
Owner/Massage Therapist
Phone
(253) 564-5828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 60401382 WA Primary

Addresses

Primary practice location

4113 Bridgeport Way W Ste B
University Place, WA 98466-4325

Mailing address

4113 Bridgeport Way W Ste B
University Place, WA 98466-4325
Phone (253) 564-5828

National Provider Directory

National Provider Directory
Tax ID family
Northwest Therapeutic Massage2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1619365830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 BRIDGEPORT WAY W STE B",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664325",
            "telephone_number": "253-564-5828",
            "fax_number": "253-564-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 BRIDGEPORT WAY W STE B",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664325",
            "telephone_number": "253-564-5828",
            "fax_number": "253-564-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST THERAPEUTIC MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "CORNS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER/MASSAGE THERAPIST",
        "authorized_official_telephone_number": "253-564-5828",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "60401382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.