Active NPI
Antoinette Evonne Wayne, LMP
- Massage Therapist
- Tacoma, WA
National Provider Identifier
1699269175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 1804 W Union Ave Ste 101
Tacoma, WA 98405 - Phone
- (951) 696-9353
- Fax
- (951) 973-7216
- NPI assigned
- Jun 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary |
Addresses
Primary practice location
1804 W Union Ave Ste 101
Tacoma, WA 98405
Mailing address
24630 Washington Ave Ste 200
Murrieta, CA 92562-6177
Phone (951) 696-9353
Other practice location 1
7308 Bridgeport Way W Ste 103
Lakewood, WA 98499-8000
Phone (253) 815-1117
Other practice location 2
5814 Graham Ave Ste 101
Sumner, WA 98390-2728
Phone (253) 891-7093
Other practice location 3
14800 Starfire Way
Tukwila, WA 98188-8502
Phone (206) 267-7811
Other practice location 4
34617 11th Pl S Ste 201
Federal Way, WA 98003-8706
Phone (253) 815-1117
Other practice location 5
4040 Orchard St W Ste 100
Fircrest, WA 98466-6610
Phone (253) 564-1560
Other practice location 6
451 SW Sedgwick Rd Ste 310
Port Orchard, WA 98367-6447
Phone (360) 874-8009
Other practice location 7
1420 3rd St SE Ste 102
Puyallup, WA 98372-3734
Phone (253) 770-1807
Other practice location 8
732 Lebo Blvd
Bremerton, WA 98310-3325
Phone (360) 479-8477
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA60848027 | Other | WA | MMT LICENSURE |
| 1699269175 | Other | WA | NPI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529884800000",
"number": "1699269175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24630 WASHINGTON AVE STE 200",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925626177",
"telephone_number": "951-696-9353",
"fax_number": "951-973-7216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1804 W UNION AVE STE 101",
"city": "TACOMA",
"state": "WA",
"postal_code": "98405",
"telephone_number": "951-696-9353",
"fax_number": "951-973-7216"
}
],
"practiceLocations": [
{
"address_1": "7308 Bridgeport Way W Ste 103",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "WA",
"postal_code": "984998000",
"country_code": "US",
"telephone_number": "253-815-1117",
"fax_number": "951-973-7216",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5814 Graham Ave Ste 101",
"address_purpose": "LOCATION",
"city": "Sumner",
"state": "WA",
"postal_code": "983902728",
"country_code": "US",
"telephone_number": "253-891-7093",
"fax_number": "951-973-7216",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14800 Starfire Way",
"address_purpose": "LOCATION",
"city": "Tukwila",
"state": "WA",
"postal_code": "981888502",
"country_code": "US",
"telephone_number": "206-267-7811",
"fax_number": "951-973-7216",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "34617 11th Pl S Ste 201",
"address_purpose": "LOCATION",
"city": "Federal Way",
"state": "WA",
"postal_code": "980038706",
"country_code": "US",
"telephone_number": "253-815-1117",
"fax_number": "951-973-7216",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4040 Orchard St W Ste 100",
"address_purpose": "LOCATION",
"city": "Fircrest",
"state": "WA",
"postal_code": "984666610",
"country_code": "US",
"telephone_number": "253-564-1560",
"fax_number": "951-973-7216",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "451 SW Sedgwick Rd Ste 310",
"address_purpose": "LOCATION",
"city": "Port Orchard",
"state": "WA",
"postal_code": "983676447",
"country_code": "US",
"telephone_number": "360-874-8009",
"fax_number": "951-973-7216",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1420 3rd St SE Ste 102",
"address_purpose": "LOCATION",
"city": "Puyallup",
"state": "WA",
"postal_code": "983723734",
"country_code": "US",
"telephone_number": "253-770-1807",
"fax_number": "951-973-7216",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "732 Lebo Blvd",
"address_purpose": "LOCATION",
"city": "Bremerton",
"state": "WA",
"postal_code": "983103325",
"country_code": "US",
"telephone_number": "360-479-8477",
"fax_number": "951-973-7216",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAYNE",
"first_name": "ANTOINETTE",
"middle_name": "EVONNE",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-19",
"last_updated": "2018-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MMT LICENSURE",
"identifier": "MA60848027",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1699269175",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.