Individual provider Active NPI

Izumi Y Masaki, LMT

  • Massage Therapist
  • Bellevue, WA
National Provider Identifier
1003413048
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60464289 Issued in WA
Practice address
606 120TH Ave NE BLDG D Ste 100
Bellevue, WA 98005-9800
Phone
(425) 688-0223
NPI assigned
Oct 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60464289 WA Primary

Addresses

Primary practice location

606 120TH Ave NE BLDG D Ste 100
Bellevue, WA 98005-9800

Mailing address

15 SW Everett Mall Way Ste G
Everett, WA 98204-2715
Phone (425) 355-5231

Other practice location 1

11901 NE Village Plaza, Suite 261
Kirkland, WA 98034-5089
Phone (425) 814-2800

Other identifiers 1

IdentifierTypeStateIssuer
MA60464289OtherWAWASHINGTON STATE DEPARTMENT OF HEALTH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bellevue@thinkvida.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA60464289WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Health Consulting, LLC PastSince Oct 4, 2020 Accepting new patients
Functional Health Consulting, LLC Massage Therapist PastSince Oct 4, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1003413048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SW EVERETT MALL WAY STE G",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042715",
            "telephone_number": "425-355-5231",
            "fax_number": "425-355-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 120TH AVE NE BLDG D STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980059800",
            "telephone_number": "425-688-0223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11901 NE Village Plaza, Suite 261",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980345089",
            "country_code": "US",
            "telephone_number": "425-814-2800",
            "fax_number": "425-823-0882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASAKI",
        "first_name": "IZUMI",
        "middle_name": "Y",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60464289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "MA60464289",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bellevue@thinkvida.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Bellevue",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "606 120TH AVE NE BLDG D STE 100",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980059800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.