Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derek Wasec Roberts, LMT

Individual provider Massage Therapist · NPI 1417776345

Derek Wasec Roberts, LMT is a Massage Therapist in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2024.

Licensed in
ID
In the registry since
2024
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

3046 S Bown Way Ste A
Boise, ID 83706-5499
Phone: (208) 318-6561
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MAS-4868 (ID)

Record details

NPI number1417776345
Entity typeIndividual (Type 1)
GenderMale
Credentials LMT
Sole proprietorNo
NPI enumeratedOctober 8, 2024
Last updated in NPPESOctober 8, 2024
Certification dateOctober 8, 2024
Mailing address217 S Powerline Rd, Nampa, ID 83686-5440

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