Paula M Davidson, MA: 60885969

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

60885969 Issued in WA

Practice address

708 Broadway Ste 170
Tacoma, WA 98402-3778

Phone

(253) 383-0577

Fax

(383) 383-0574

NPI assigned

Oct 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Brilliant Life Chiropractic, LLC

  • Chiropractor
  • Tacoma, WA
  • NPI 1063666444
  NPD (past)
• Ignite a Path to Wellness

  • Counselor
  • Tacoma, WA
  • NPI 1588299515
  NPD (past)

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1982170643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 BROADWAY STE 170",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023778",
            "telephone_number": "253-383-0577",
            "fax_number": "253-383-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 BROADWAY STE 170",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023778",
            "telephone_number": "253-383-0577",
            "fax_number": "383-383-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "PAULA",
        "middle_name": "M",
        "credential": "MA: 60885969",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60885969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "14388756",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Davidson
• Douglas T Davidson III, M.D.
• Elizabeth Davidson
• Howard Davidson, M.D.
• Mikayla M Davidson
• Thomas Davidson
• Alyce June Davie, AGENCY AFFILIATED CO
• Davis Dental Group
• Adrian Davis, PMHNP
• Al Zachery Davis III

• Massage Therapist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.