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1336323690 NPI number — OSHA GRACE CEDARCROFT L.M.P.

NPI Number: 1336323690
Health Care Provider/Practitioner: OSHA GRACE CEDARCROFT L.M.P.

Information about “1336323690” NPI (OSHA GRACE CEDARCROFT L.M.P.) exists in 1336323690 in HTML format HTML  |  1336323690 in plain Text format TXT  |  1336323690 in PDF (Portable Document Format) PDF  |  1336323690 in an XML format XML  formats.

NPI Number : 1336323690 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336323690",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CEDARCROFT",
    "FirstName": "OSHA",
    "MiddleName": "GRACE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "L.M.P.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HAMEL",
    "OtherFirstName": "AMY",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "L.M.P.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "4005 N 19TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TACOMA",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98406-4705",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "253-230-4957",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4005 N 19TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TACOMA",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98406-4705",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "253-230-4957",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/21/2007",
    "LastUpdateDate": "09/29/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225700000X",
        "TaxonomyName": "Massage Therapist",
        "LicenseNumber": "MA00021278",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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