Active NPI
Ronald Eugene Mogensen, LMP
- Massage Therapist
- Port Orchard, WA
National Provider Identifier
1942216155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 1963 Bethel Rd SE
Port Orchard, WA 98366-3108 - Phone
- (360) 621-2684
- NPI assigned
- Jul 31, 2006
- 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 | WA | Primary |
Addresses
Primary practice location
1963 Bethel Rd SE
Port Orchard, WA 98366-3108
Mailing address
PO Box 1572
Port Orchard, WA 98366-0139
Phone (360) 621-2684
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0199123 | Other | WA | LABOR & INDUSTRIES |
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 |
|---|---|---|---|
| 602511506 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191801600000",
"number": "1942216155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1572",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983660139",
"telephone_number": "360-621-2684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1963 BETHEL RD SE",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983663108",
"telephone_number": "360-621-2684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGENSEN",
"first_name": "RONALD",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0199123",
"state": "WA"
}
],
"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 Oct 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.