Evan Macdonald, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501015035 Issued in MI

Practice address

1421 60TH St SE
Kentwood, MI 49508-7065

Phone

(616) 610-1179

NPI assigned

Jun 1, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1649919309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PORT SHELDON ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494289341",
            "telephone_number": "616-610-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 60TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087065",
            "telephone_number": "616-610-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "EVAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501015035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine H Luczkowski
• Brooke Anna Lundie
• Kaitlyn Elizabeth Goss Luth, BCBA
• Luxottica Retail North America Inc
• Beth Macauley, PH.D., CCC-SLP, HPCS
• Swetha Madala, D.D.S
• Denise Maldonado
• Heather Anne Mallory-May, D.D.S.
• Stephen Michael Mancewicz, DDS
• Dawn Elizabeth-Reed Mango, RN

• Massage Therapist in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.