Active NPI
Ayrton T Ibarra
- Massage Therapist
- Covington, WA
National Provider Identifier
1740841113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60817446
- Practice address
- 17615 SE 272ND St Ste 104
Covington, WA 98042-4957 - Phone
- (206) 612-1889
- NPI assigned
- Jun 25, 2019
- Sex
- Male
- 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 | MA60817446 | WA | Primary |
Addresses
Primary practice location
17615 SE 272ND St Ste 104
Covington, WA 98042-4957
Mailing address
223 K St SE
Auburn, WA 98002-5742
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 |
|---|---|---|---|
| MA60817446 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561420800000",
"number": "1740841113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 K ST SE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980025742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17615 SE 272ND ST STE 104",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980424957",
"telephone_number": "206-612-1889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBARRA",
"first_name": "AYRTON",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-25",
"last_updated": "2019-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60817446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.