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NPI Code Detail

MEDICARE: AMY FALGOUT LMP

MEDICARE: AMY FALGOUT LMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMASS.MA.70023198WA

General Provider Information

NPI Number : 1578427134
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY FALGOUT LMP
Provider Business Mailing Address
First Line : PO BOX 692
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-0692
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1800 SE MILE HILL DR STE 150
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-3517
Country : US
Telephone Number : 360-874-0232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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