Coral A Van Dyne, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA0025124 Issued in WA

Practice address

505 E 3Rd Ave
Spokane, WA 99202-1426

Phone

(509) 838-2531

NPI assigned

Dec 16, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Coral A Grubbs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1629371455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021334",
            "telephone_number": "509-838-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E 3RD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021426",
            "telephone_number": "509-838-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYNE",
        "first_name": "CORAL",
        "middle_name": "A",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA0025124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORAL",
            "last_name": "GRUBBS",
            "middle_name": "A",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ean James Zahn Van Bramer, DO
• Miranda L Van de Loo, DNP, FNP-BC, PMHNP
• Olivia Van de Rostyne
• Jordon Van de Velde, DO
• Shawn M Van Dingenen
• Megan Elaine Van Fleet, PHARMD
• Jason Michael Van Gelder, PMHNP-BC
• Michael Jacobus Van Gelder, M.S., M.N., PMHNP
• John Andrew Van Gemert, DDS PS
• Lauren Nicole Van Gemert, D.D.S.

• Massage Therapist in Spokane, WA
• Providers in Spokane, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.