Individual provider Active NPI

Moranda Stauffer, LMP

  • Massage Therapist
  • Port Orchard, WA
National Provider Identifier
1912203910
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60183656 Issued in WA
Practice address
873 Bethel Ave
Port Orchard, WA 98366-4229
Phone
(360) 876-1500
Fax
(360) 876-1666
NPI assigned
Feb 8, 2011
Last updated
Feb 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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 MA60183656 WA Primary

Addresses

Primary practice location

873 Bethel Ave
Port Orchard, WA 98366-4229

Mailing address

1871 SE Van Skiver Rd
Port Orchard, WA 98367-8516
Phone (360) 362-6459

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
MA60183656WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Chiropractic, Inc. PastSince Jun 2, 2003 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": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1912203910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 SE VAN SKIVER RD",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983678516",
            "telephone_number": "360-362-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 BETHEL AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664229",
            "telephone_number": "360-876-1500",
            "fax_number": "360-876-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUFFER",
        "first_name": "MORANDA",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60183656",
            "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 Feb 8, 2011; 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.