Individual provider Active NPI

Amber D Smith, LMT

  • Massage Therapist
  • Moses Lake, WA
National Provider Identifier
1861274110
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
61479019 Issued in WA
Practice address
1217 E Wheeler Rd
Moses Lake, WA 98837-1859
Phone
(509) 350-5616
NPI assigned
Oct 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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 61479019 WA Primary

Addresses

Primary practice location

1217 E Wheeler Rd
Moses Lake, WA 98837-1859

Mailing address

1148 S Eastlake Dr
Moses Lake, WA 98837-2114
Phone (425) 691-8550

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
61479019WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Knot Release Therapies Inc Massage Therapist CurrentSince Oct 22, 2023 Accepting new patients

Locations

1217 E Wheeler Rd
Moses Lake, WA 98837
Phone (509) 350-5616

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": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1861274110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 S EASTLAKE DR",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372114",
            "telephone_number": "425-691-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 E WHEELER RD",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371859",
            "telephone_number": "509-350-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMBER",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "61479019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.