Clyde O McDade, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00010222 Issued in WA

Practice address

11008 Gravelly Lake Dr SW
Lakewood, WA 98499-1332

Phone

(360) 763-9439

Fax

(360) 767-3087

NPI assigned

Dec 22, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Stress Relief Solutions

  • Massage Therapist
  • Olympia, WA
  • NPI 1124581434
  NPD Authorized official

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1982680815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11008 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991332",
            "telephone_number": "360-763-9439",
            "fax_number": "360-767-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11008 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991332",
            "telephone_number": "360-763-9439",
            "fax_number": "360-767-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDADE",
        "first_name": "CLYDE",
        "middle_name": "O",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00010222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela E. McCormack, CPC
• Sierra McCormick
• Anna Christine McCracken, CNM
• Blaire Dagostin McCurry, DPT
• Christopher Damion McCusker, CPC
• Andrea Shermaine McDaniel, SWAICL
• Daija Monet McDaniel
• Sally A McDaniel, MA
• Cody McDonald, LCPO
• Doreen McDonald, BA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.