Tri Pain Management & Sports Rehabilitation

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60446352 Issued in WA

Legal business name

TRI PAIN MANAGEMENT & SPORTS REHABILITATION

Practice address

3324 S Grand Blvd
Spokane, WA 99203-2619

Phone

(509) 218-9520

Fax

(509) 838-1780

NPI assigned

Feb 1, 2016

Last updated

Feb 2, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Terry Ray Impecoven Jr.

Title

Massage Therapist

Phone

(509) 218-9520

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1689032096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10912 E 5TH CT",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992062851",
            "telephone_number": "509-218-9520",
            "fax_number": "509-838-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3324 S GRAND BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992032619",
            "telephone_number": "509-218-9520",
            "fax_number": "509-838-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI PAIN MANAGEMENT & SPORTS REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "IMPECOVEN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "MASSAGE THERAPIST",
        "authorized_official_telephone_number": "509-218-9520",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60446352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.