Active NPI
Robin L Moon, LMP
- Massage Therapist
- Kent, WA
National Provider Identifier
1730321415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60040614
- Practice address
- 15220 SE 272ND St
Suite G
Kent, WA 98042-4241 - Phone
- (253) 630-6768
- Fax
- (253) 630-6639
- NPI assigned
- Mar 27, 2009
- Last updated
- Mar 29, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | MA60040614 | WA | Primary |
Addresses
Primary practice location
15220 SE 272ND St
Suite G
Kent, WA 98042-4241
Mailing address
15220 SE 272ND St
Suite G
Kent, WA 98042-4241
Phone (253) 630-6768
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60040614 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elle a Clinical Day Spa, Inc | Past | 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, 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": "1238112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238284800000",
"number": "1730321415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15220 SE 272ND ST",
"address_2": "SUITE G",
"city": "KENT",
"state": "WA",
"postal_code": "980424241",
"telephone_number": "253-630-6768",
"fax_number": "253-630-6639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15220 SE 272ND ST",
"address_2": "SUITE G",
"city": "KENT",
"state": "WA",
"postal_code": "980424241",
"telephone_number": "253-630-6768",
"fax_number": "253-630-6639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "ROBIN",
"middle_name": "L",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-27",
"last_updated": "2009-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60040614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.