NPIMap

Organization Active NPI

Rejuvenation of Ballard

Doing business as rejuvenation

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1730233669
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
00014583 Issued in WA
Legal business name
REJUVENATION OF BALLARD
Doing business as
rejuvenation
Practice address
4775 Ballard Ave NW
Seattle, WA 98107-4810
Phone
(206) 778-0063
Fax
(206) 297-0838
NPI assigned
Jan 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Darian A Weaver, LMPNPI 1952453169
Title
Owner
Phone
(206) 778-0063

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 00014583 WA Primary

Addresses

Primary practice location

4775 Ballard Ave NW
Seattle, WA 98107-4810

Mailing address

4775 Ballard Ave NW
Seattle, WA 98107-4810
Phone (206) 778-0063

Other names 1

  • rejuvenation Doing business as

National Provider Directory

National Provider Directory

Locations

4775 Ballard Ave NW
Seattle, WA 98107
Phone (206) 778-0063

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730233669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 BALLARD AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074810",
            "telephone_number": "206-778-0063",
            "fax_number": "206-297-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 BALLARD AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074810",
            "telephone_number": "206-778-0063",
            "fax_number": "206-297-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATION OF BALLARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "DARIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-778-0063",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "00014583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "rejuvenation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.