Active NPI
Michael Nebeker, MA 60771411
- Massage Therapist
- Lake Stevens, WA
National Provider Identifier
1871015321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 60771411
- Practice address
- 2130 97TH Dr SE
Lake Stevens, WA 98258-4730 - Phone
- (425) 359-2734
- NPI assigned
- Jul 16, 2017
- Last updated
- Jul 16, 2017
- Sex
- Male
- 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 | 60771411 | WA | Primary |
Addresses
Primary practice location
2130 97TH Dr SE
Lake Stevens, WA 98258-4730
Mailing address
2130 97TH Dr SE
Lake Stevens, WA 98258-4730
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60771411 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500163200000",
"number": "1871015321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2130 97TH DR SE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982584730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2130 97TH DR SE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982584730",
"telephone_number": "425-359-2734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEBEKER",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "MA 60771411",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-16",
"last_updated": "2017-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "60771411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Stevens, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.