Individual provider Active NPI

Payton Rain Matherly, LMT

  • Massage Therapist
  • Fircrest, WA
National Provider Identifier
1689197204
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60761995 Issued in WA
Practice address
6314 19TH St W Ste 11
Fircrest, WA 98466-6223
Phone
(253) 267-8188
NPI assigned
Jul 25, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 MA60761995 WA Primary

Addresses

Primary practice location

6314 19TH St W Ste 11
Fircrest, WA 98466-6223

Mailing address

6314 19TH St W Ste 11
Fircrest, WA 98466-6223
Phone (253) 267-8188

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
MA60761995WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PM Health Group PLLC CurrentSince Jul 24, 2022 Accepting new patients
DT Smith Healthgroup PLLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

6314 19th St W
Ste 11
Fircrest, WA 98466
Phone (253) 267-8188

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689197204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6314 19TH ST W STE 11",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666223",
            "telephone_number": "253-267-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 19TH ST W STE 11",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666223",
            "telephone_number": "253-267-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERLY",
        "first_name": "PAYTON",
        "middle_name": "RAIN",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60761995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fircrest, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.