Individual provider Active NPI

Sureerat Wongrat-Burson, LMT

  • Massage Therapist
  • Bellevue, WA
National Provider Identifier
1861927683
Registry record updated Apr 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60602293 Issued in WA
Practice address
515 116TH Ave NE Ste 113
Bellevue, WA 98004-5225
Phone
(425) 802-2959
NPI assigned
Apr 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2017

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 MA60602293 WA Primary

Addresses

Primary practice location

515 116TH Ave NE Ste 113
Bellevue, WA 98004-5225

Mailing address

13320 127TH PL NE
Kirkland, WA 98034-5416
Phone (425) 802-2959

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
MA60602293WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1493510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493510400000",
    "number": "1861927683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13320 127TH PL NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980345416",
            "telephone_number": "425-802-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 116TH AVE NE STE 113",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045225",
            "telephone_number": "425-802-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONGRAT-BURSON",
        "first_name": "SUREERAT",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-30",
        "last_updated": "2017-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60602293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.

Verify at the official NPI Registry.