MR. CHARLES RANDOLPH FISK LMP NPI 1275719494

NPI Information

NPI: 1275719494
Provider Name: MR. CHARLES RANDOLPH FISK, LMP
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
18124 114TH ST E
BONNEY LAKE, WA
ZIP 98391
Phone: (253) 229-5819
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MR. Charles Randolph Fisk, LMP is a massage therapist in Bonney Lake, WA. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. MR. Charles Randolph Fisk, LMP NPI is 1275719494. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

18124 114TH ST E
BONNEY LAKE, WA
ZIP 98391-168
Phone: (253) 229-5819

The enumeration date for this NPI number is 1/17/2008 and was last updated on 11/18/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		MA00017977	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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