Active NPI
Bruce R Matthews, MA 60231903
- Massage Therapist
- Vancouver, WA
National Provider Identifier
1649567322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60231903
- Practice address
- 16111 SE McGillivray Blvd Ste a
Vancouver, WA 98683-9033 - Phone
- (360) 254-0994
- NPI assigned
- Jul 1, 2011
- Sex
- Male
- Sole proprietor
- No
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 | MA 60231903 | WA | Primary |
Addresses
Primary practice location
16111 SE McGillivray Blvd Ste a
Vancouver, WA 98683-9033
Mailing address
14002 NE 7TH Way
Vancouver, WA 98684-7341
Phone (360) 852-1765
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 60231903 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1649567322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14002 NE 7TH WAY",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986847341",
"telephone_number": "360-852-1765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16111 SE MCGILLIVRAY BLVD STE A",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986839033",
"telephone_number": "360-254-0994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "BRUCE",
"middle_name": "R",
"credential": "MA 60231903",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-01",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60231903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.