Individual provider Active NPI

Madisen Dailly

  • Massage Therapist
  • Port Orchard, WA
National Provider Identifier
1790159044
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60615521 Issued in WA
Practice address
2501 SE Mile Hill Dr Ste A101
Port Orchard, WA 98366-3514
Phone
(360) 895-4843
NPI assigned
Nov 24, 2015
Last updated
Nov 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 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 MA60615521 WA Primary

Addresses

Primary practice location

2501 SE Mile Hill Dr Ste A101
Port Orchard, WA 98366-3514

Mailing address

1267 Peru Ave E
Port Orchard, WA 98366-8307
Phone (360) 621-8240

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
MA60615521WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Chiropractic Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1790159044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 PERU AVE E",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983668307",
            "telephone_number": "360-621-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 SE MILE HILL DR STE A101",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663514",
            "telephone_number": "360-895-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAILLY",
        "first_name": "MADISEN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60615521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.