Individual provider Active NPI

Fuming Gong

  • Massage Therapist
  • Shoreline, WA
National Provider Identifier
1700621968
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
61414289 Issued in WA
Practice address
20124 Ballinger Way NE Ste a-02
Shoreline, WA 98155-1117
Phone
(206) 366-1111
NPI assigned
Jun 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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 61414289 WA Primary

Addresses

Primary practice location

20124 Ballinger Way NE Ste a-02
Shoreline, WA 98155-1117

Mailing address

911 N 130TH St
Seattle, WA 98133-7502
Phone (206) 445-4918

Other practice location 1

8704 Rainier Ave S
Seattle, WA 98118-4927
Phone (206) 772-0299

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
61414289WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tres Bien Massage Massage Therapist PastSince Jun 30, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1700621968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N 130TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981337502",
            "telephone_number": "206-445-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20124 BALLINGER WAY NE STE A-02",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551117",
            "telephone_number": "206-366-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8704 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981184927",
            "country_code": "US",
            "telephone_number": "206-772-0299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONG",
        "first_name": "FUMING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "61414289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.