King Wittman, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

14939 Issued in HI

Practice address

40 N Market St
Wailuku, HI 96793-1718

Phone

(808) 242-8788

Fax

(808) 242-8788

NPI assigned

Jan 17, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ize Goodfriend Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Green Ti Boutique and Massage LLC

  • Massage Therapist
  • Wailuku, HI
  • NPI 1801237045
  NPD (past)

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1982140778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 N MARKET ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931718",
            "telephone_number": "808-242-8788",
            "fax_number": "808-242-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N MARKET ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931718",
            "telephone_number": "808-242-8788",
            "fax_number": "808-242-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTMAN",
        "first_name": "KING",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "14939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IZE",
            "last_name": "GOODFRIEND",
            "credential": "LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kimberley M. I. Wirsing, M.D.
• Noel J Withers, APRN
• Rachel G. Withers, PA C
• David Jason Wittenberg, PSY.D.
• Heather Lee Wittenberg, PSY.D.
• Michael Lucian Wojciechowski, OTR
• Marla R Wojtanowicz, LMFT
• Pamela D. Wolz, PA-C
• Brenda Yvonne Wong, RPT
• Evone K. Wong, O.D.

• All providers in Wailuku, HI
• Massage Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.