Individual provider Active NPI

Scott Farley Buck, STATE LICENSE

  • Massage Therapist
  • Port Angeles, WA
National Provider Identifier
1639350481
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00018373 Issued in WA
Practice address
1053 S Bagley Creek Rd
Port Angeles, WA 98362-7149
Phone
(360) 775-0867
Fax
(360) 417-8161
NPI assigned
Nov 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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 MA00018373 WA Primary

Addresses

Primary practice location

1053 S Bagley Creek Rd
Port Angeles, WA 98362-7149

Mailing address

1053 S Bagley Creek Rd
Port Angeles, WA 98362-7149
Phone (360) 775-0867

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
MA00018373WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1639350481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 S BAGLEY CREEK RD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627149",
            "telephone_number": "360-775-0867",
            "fax_number": "360-417-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 S BAGLEY CREEK RD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627149",
            "telephone_number": "360-775-0867",
            "fax_number": "360-417-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "SCOTT",
        "middle_name": "FARLEY",
        "name_prefix": "Mr.",
        "credential": "STATE LICENSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00018373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.