Randal Scott Fruchter, CMT , BCTMB , HHP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

61233543 Issued in WA

Practice address

16703 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4301

Phone

(360) 519-7631

NPI assigned

Mar 15, 2018

Last updated

May 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Theology

State licenses

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1740783869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SE FRENCH RD APT D",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643747",
            "telephone_number": "949-616-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16703 SE MCGILLIVRAY BLVD STE 175",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834301",
            "telephone_number": "360-519-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUCHTER",
        "first_name": "RANDAL",
        "middle_name": "SCOTT",
        "credential": "CMT , BCTMB , HHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "71250",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "61233543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.