Rendall Davis, LMT

Individual provider Active NPI Massage Therapist · Sumner, WA

NPI 1760960488 · NPPES record last updated Aug 3, 2018

Key facts

NPI
1760960488
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA60597582 (WA)
Practice address
16101 64TH St E
Sumner, WA 98390-3069
Phone
(253) 750-0453
Fax
(253) 750-3129
NPI assigned
Aug 3, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA60597582WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Massage Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60597582 WA Yes

Addresses

Primary practice location

16101 64TH St E
Sumner, WA 98390-3069

Mailing address

6050 Tacoma Mall Blvd Ste 300
Tacoma, WA 98409-6828
Phone (253) 581-5200

Other providers in Sumner, WA

All providers in Sumner, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.