Individual provider Active NPI

Cherie Dubeau, LMP

  • Massage Therapist
  • Issaquah, WA
National Provider Identifier
1679890982
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 60146601 Issued in WA
Practice address
4406 W Lake Sammamish Pkwy SE
Issaquah, WA 98027-9774
Phone
(360) 941-1615
Fax
(425) 643-9170
NPI assigned
Apr 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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 MA 60146601 WA Primary

Addresses

Primary practice location

4406 W Lake Sammamish Pkwy SE
Issaquah, WA 98027-9774

Mailing address

4406 W Lake Sammamish Pkwy SE
Issaquah, WA 98027-9774
Phone (360) 941-1615

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
MA 60146601WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1679890982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 W LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980279774",
            "telephone_number": "360-941-1615",
            "fax_number": "425-643-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406 W LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980279774",
            "telephone_number": "360-941-1615",
            "fax_number": "425-643-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBEAU",
        "first_name": "CHERIE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60146601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.