Active NPI
Sandra De'Ak, LMT
- Massage Therapist
- White Salmon, WA
National Provider Identifier
1780110585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 4821
- Practice address
- 288 E Jewett Blvd
Suite 400
White Salmon, WA 98672-3000 - Phone
- (503) 516-6535
- NPI assigned
- May 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 4821 | OR | Primary |
Addresses
Primary practice location
288 E Jewett Blvd
Suite 400
White Salmon, WA 98672-3000
Mailing address
171 Acme Rd
White Salmon, WA 98672-8202
Phone (503) 516-6535
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 |
|---|---|---|---|
| 4821 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494460800000",
"number": "1780110585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 ACME RD",
"city": "WHITE SALMON",
"state": "WA",
"postal_code": "986728202",
"telephone_number": "503-516-6535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "288 E JEWETT BLVD",
"address_2": "SUITE 400",
"city": "WHITE SALMON",
"state": "WA",
"postal_code": "986723000",
"telephone_number": "503-516-6535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE'AK",
"first_name": "SANDRA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-11",
"last_updated": "2017-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "4821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Salmon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.