Active NPI
Andressa Duarte De Meneses, LMT
- Massage Therapist
- Bonney Lake, WA
National Provider Identifier
1821847229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA61220063
- Practice address
- 10004 204TH Ave E Ste 3100
Bonney Lake, WA 98391-6540 - Phone
- (253) 987-7509
- NPI assigned
- May 16, 2024
- Sex
- Female
- Sole proprietor
- No
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 | MA61220063 | WA | Primary |
Addresses
Primary practice location
10004 204TH Ave E Ste 3100
Bonney Lake, WA 98391-6540
Mailing address
6050 Tacoma Mall Blvd Ste 300
Tacoma, WA 98409-6828
Phone (253) 581-5200
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 |
|---|---|---|---|
| MA61220063 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Massage Therapist | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1821847229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6050 TACOMA MALL BLVD STE 300",
"city": "TACOMA",
"state": "WA",
"postal_code": "984096828",
"telephone_number": "253-581-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10004 204TH AVE E STE 3100",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983916540",
"telephone_number": "253-987-7509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE MENESES",
"first_name": "ANDRESSA",
"middle_name": "DUARTE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-16",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA61220063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.