NPIMap

Individual provider Active NPI

Richard Austin Davenport, LMP

  • Massage Therapist
  • Tacoma, WA
National Provider Identifier
1760612469
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60091736 Issued in WA
Practice address
285 Spring St
Tacoma, WA 98250
Phone
(360) 378-3637
NPI assigned
Jul 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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 MA60091736 WA Primary

Addresses

Primary practice location

285 Spring St
Tacoma, WA 98250

Mailing address

PO Box 2491
Friday Harbor, WA 98250-2491
Phone (360) 298-6848

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
MA60091736WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lavendera Day Spa LTD Massage Therapist Past Accepting new patients
Lavendera Massage LLC Massage Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1760612469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2491",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982502491",
            "telephone_number": "360-298-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SPRING ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98250",
            "telephone_number": "360-378-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "RICHARD",
        "middle_name": "AUSTIN",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60091736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.