Paudra Nathan Foroutan, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61369510 Issued in WA

Practice address

22626 NE Inglewood Hill Rd Apt 524
Sammamish, WA 98074-5008

Phone

(425) 765-6036

NPI assigned

Mar 13, 2024

Last updated

Mar 13, 2024By the provider in NPPES

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": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1659139681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22626 NE INGLEWOOD HILL RD APT 524",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980745008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22626 NE INGLEWOOD HILL RD APT 524",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980745008",
            "telephone_number": "425-765-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOROUTAN",
        "first_name": "PAUDRA",
        "middle_name": "NATHAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61369510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.