David Bray, LMT

Key facts

NPI

1740905967

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

License

MAS-1499 (ID)

Practice address

9751 N Government Way Ste 4
Hayden, ID 83835-9645

Phone

(208) 696-1330

Fax

(208) 684-7834

NPI assigned

Oct 10, 2022

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 10, 2022.

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1740905967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9751 N GOVERNMENT WAY STE 4",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359645",
            "telephone_number": "208-696-1330",
            "fax_number": "208-684-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9751 N GOVERNMENT WAY STE 4",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359645",
            "telephone_number": "208-696-1330",
            "fax_number": "208-684-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "DAVID",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS-1499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

• Jessica Borges, LM
• Roberta Boyd, LPC
• Carolyn P Brainard, LMP
• Jennifer Dawn Brakeman, LM
• Brave Connections Mental Health Therapy, LLC
• Breazeal & Associates PA Inc
• Larry D Breazeal, O.D.
• Jeffrey James Brogan
• Brad W Brososky, MD
• Brown Family Chiropractic LLC

All providers in Hayden, ID · Massage Therapist in Idaho