MR. MICHAEL GIBBONS (NPI# 1083825905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083825905 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL GIBBONS |
| Credential | LMP |
| Practice Address |
19102 State Route 410 E Ste A Bonney Lake WA 98391-8449 |
| Mailing Address |
P.o. Box 1413 Puyallup WA 98371-0204 |
| Practice Telephone | 2538636378 |
| Practice Fax Number | 2538636429 |
| Mailing Telephone | 2538636378 |
| Mailing Fax Number | 2538636429 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00013609 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | REGENCE | 4188GI | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801389788 | Michael Thomas Gibbons | Surgery | Surgery Clinic, 1801 Sunset Drive, Columbia, SC 29203 | 2018-06-14 |
| 1396153839 | Michael Gibbons | Skilled Nursing Facility | 93 Jordan Blvd, Delmar, NY 12054-4105 | 2014-07-29 |
| 1083895999 | Michael Joseph Gibbons | Registered Nurse | 12 Scenic Hills Dr, Ridge, NY 11961-3022 | 2007-11-19 |
| 1184693574 | Michael T Gibbons | Nurse Anesthetist, Certified Registered | 421 Se Osceola St, Ste 3, Stuart, FL 34994-2505 | 2006-03-16 |
| 1538167234 | Michael J Gibbons | Dentist | 7477 E Doubletree Ranch Rd, Suite 200, Scottsdale, AZ 85258-2048 | 2005-07-07 |
| 1063888253 | Michael Gibbons | Nurse Practitioner | 173 Chelsea St, Everett, MA 02149-4632 | 2015-08-11 |
| 1215126925 | Michael T Gibbons | Emergency Medicine | 1296 Tod Pl Nw, Suite 200, Warren, OH 44485-2474 | 2007-10-18 |
| 1285838763 | Michael D Gibbons | Hospitalist | 4220 Harding Rd, Suite 500, Nashville, TN 37205-2005 | 2007-06-11 |
| 1659598563 | Michael Gibbons | Counselor | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-04-20 |
| 1104970664 | Michael P Gibbons | Dentist | 4801 W Peterson Ave, Suite 550, Chicago, IL 60646-5795 | 2007-01-22 |
| Street Address |
19102 STATE ROUTE 410 E STE A |
| City | BONNEY LAKE |
| State | WA |
| Zip Code | 98391-8449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396787164 | Errol Justin Medel | Chiropractor | 19102 State Route 410 E Ste A, Bonney Lake, WA 98391-8449 | 2006-06-13 |
| 1588188940 | Anastacia M Candazo | Massage Therapist | 19102 State Route 410 E Ste A, Bonney Lake, WA 98391-8449 | 2017-07-27 |
| 1619402625 | Trent A Tellier | Massage Therapist | 19102 State Route 410 E Ste A, Bonney Lake, WA 98391-8449 | 2017-04-27 |
| 1720387525 | Jessica Thor | Specialist | 19102 State Route 410 E Ste A, Bonney Lake, WA 98391-8449 | 2011-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218814 | Lenny Yann | Pharmacist | 21301 Wa 410, Bonney Lake, WA 98391 | 2020-09-08 |
| 1497244552 | Kayla Grasso | Technician, Other | 18444 139th Street East, Bonney Lake, WA 98391 | 2018-05-04 |
| 1407359151 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 9801 204th Ave E, Bonney Lake, WA 98391 | 2018-03-08 |
| 1992217152 | Rachel Renee Andringa | Massage Therapist | 19102 Wa-410, Bonney Lake, WA 98391 | 2017-10-27 |
| 1437679099 | Emily A. Hansen | Occupational Therapist | 12202 209th Ave Ct. E., Liberty Ridge Elementary School, Bonney Lake, WA 98391 | 2017-06-26 |
| 1245782986 | Advance Behavior Education Continuum, Inc | Behavioral Analyst | 2305 164th Ave Ct, Bonney Lake, WA 98391 | 2016-10-28 |
| 1619343191 | Lauren Christine Difolco | Specialist | 10920 199th Ave. Ct. E., Bonney Lake Hs, Bonney Lake, WA 98391 | 2015-08-19 |
| 1699018192 | Michael Nelson | Dentist | 2803 176th Ave East, Lake Tapps, WA 98391 | 2013-04-03 |
| 1700141066 | Jacqueline Nguyen | Pharmacist | 20025 State Route 410 E, Bonney Lake, WA 98391 | 2012-07-11 |
| 1265737860 | Braden Shingleton | Massage Therapist | 19102 Sr 410 E Suite A, Bonney Lake, WA 98391 | 2011-01-13 |
| Find all providers in zip 98391 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154820728 | Jayce Ellis | Massage Therapist | 10202 199th Ave E, Bonney Lake, WA 98391-5929 | 2018-02-08 |
| 1992217152 | Rachel Renee Andringa | Massage Therapist | 19102 Wa-410, Bonney Lake, WA 98391 | 2017-10-27 |
| 1699214502 | Jessie Horton | Massage Therapist | 18401 Veterans Memorial Dr E, Bonney Lake, WA 98391-7053 | 2017-02-13 |
| 1659762011 | Kandace Neufeld | Massage Therapist | 18507 94th Street Ct E, Bonney Lake, WA 98391-8556 | 2015-02-06 |
| 1871919662 | Samantha Guthrie | Massage Therapist | 10004 204th Ave E Ste 3100, Bonney Lake, WA 98391-6540 | 2014-03-17 |
| 1811232473 | Linda Kay Mccoy | Massage Therapist | 18310 State Route 410 E, Bonney Lake, WA 98391-8532 | 2012-12-06 |
| 1134489149 | Courtney Gail Cavelti | Massage Therapist | 18401 Sumner Buckley Hwy, Bonney Lake, WA 98391-7053 | 2012-05-23 |
| 1871874511 | Chrystal Dawn Rubert | Massage Therapist | 12814 220th Ave E, Bonney Lake, WA 98391-7624 | 2011-09-08 |
| 1962782094 | Nicole Marie Evans | Massage Therapist | 18801 Veterans Memorial Dr E, Suite 5, Bonney Lake, WA 98391-5204 | 2011-08-20 |
| 1295023109 | Robert C Hackett | Massage Therapist | 18209 Sr 410 E Ste 100, Bonney Lake, WA 98391-5146 | 2011-07-12 |
| Find all providers in BONNEY LAKE | ||||
| City | BONNEY LAKE |
| Zip Code | 98391 |
Please comment or provide details below to improve the information on MR. MICHAEL GIBBONS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.