Active NPI
Miki Larson, LMP
- Massage Therapist
- Auburn, WA
National Provider Identifier
1033360755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00025170
- Practice address
- 1101 Super Mall Way
#1269
Auburn, WA 98001 - Phone
- (253) 269-0261
- Fax
- (253) 269-0202
- NPI assigned
- Oct 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00025170 | WA | Primary |
Addresses
Primary practice location
1101 Super Mall Way
#1269
Auburn, WA 98001
Mailing address
9414 Ridge Top Blvd
#103
Silverdale, WA 98383
Phone (360) 434-1051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 230529 | Other | WA | WA ST. DEPT OF LABOR & INDUSTRIES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00025170 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222819200000",
"number": "1033360755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9414 RIDGE TOP BLVD",
"address_2": "#103",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "98383",
"telephone_number": "360-434-1051",
"fax_number": "360-437-2345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 SUPER MALL WAY",
"address_2": "#1269",
"city": "AUBURN",
"state": "WA",
"postal_code": "98001",
"telephone_number": "253-269-0261",
"fax_number": "253-269-0202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "MIKI",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-01",
"last_updated": "2008-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00025170",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA ST. DEPT OF LABOR & INDUSTRIES",
"identifier": "230529",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.