Individual provider Active NPI

Anita L. Funseth, L.M.P.

  • Massage Therapist
  • Longview, WA
National Provider Identifier
1679790851
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00009138 Issued in WA
Practice address
1318 Washington Way Ste B
Longview, WA 98632-3974
Phone
(360) 425-8909
Fax
(360) 425-6905
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 MA00009138 WA Primary

Addresses

Primary practice location

1318 Washington Way Ste B
Longview, WA 98632-3974

Mailing address

2527 30TH Ave
Longview, WA 98632-4364
Phone (360) 414-1386

Other identifiers 1

IdentifierTypeStateIssuer
188330OtherWADEPT OF LABOR & INDS.

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
MA00009138WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679790851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 30TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324364",
            "telephone_number": "360-414-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 WASHINGTON WAY STE B",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323974",
            "telephone_number": "360-425-8909",
            "fax_number": "360-425-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNSETH",
        "first_name": "ANITA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00009138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDS.",
            "identifier": "188330",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.