Individual provider Active NPI

Rebecca J De la Mater, LMT

  • Massage Therapist
  • Bremerton, WA
National Provider Identifier
1750079695
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60931988 Issued in WA
Practice address
9218 Brownsville Hwy NE
Bremerton, WA 98311-9233
Phone
(360) 286-2414
NPI assigned
Apr 28, 2023
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60931988 WA Primary

Addresses

Primary practice location

9218 Brownsville Hwy NE
Bremerton, WA 98311-9233

Mailing address

1115 NE Sockeye CT
Bremerton, WA 98311-9473
Phone (808) 228-3986

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

LicenseStateTypeSpecialty
MA60931988WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1750079695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 NE SOCKEYE CT",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983119473",
            "telephone_number": "808-228-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9218 BROWNSVILLE HWY NE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983119233",
            "telephone_number": "360-286-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA MATER",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60931988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.