Active NPI
Susan Lee Upchurch, LMP
- Massage Therapist
- Renton, WA
National Provider Identifier
1942516372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60168226
- Practice address
- 201 Union Ave SE
#18
Renton, WA 98059-5184 - Phone
- (425) 306-8333
- NPI assigned
- Aug 23, 2010
- Sex
- Female
- Sole proprietor
- No
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 | MA 60168226 | WA | Primary |
Addresses
Primary practice location
201 Union Ave SE
#18
Renton, WA 98059-5184
Mailing address
201 Union Ave SE
#18
Renton, WA 98059-5184
Phone (425) 306-8333
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 |
|---|---|---|---|
| MA 60168226 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282780800000",
"number": "1942516372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 UNION AVE SE",
"address_2": "#18",
"city": "RENTON",
"state": "WA",
"postal_code": "980595184",
"telephone_number": "425-306-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 UNION AVE SE",
"address_2": "#18",
"city": "RENTON",
"state": "WA",
"postal_code": "980595184",
"telephone_number": "425-306-8333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UPCHURCH",
"first_name": "SUSAN",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-23",
"last_updated": "2010-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60168226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.