Active NPI
Patricia L Burgess, LMP
- Massage Therapist
- Lake Stevens, WA
National Provider Identifier
1053663815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60235977
- Practice address
- 9623 32ND St SE
Lake Stevens, WA 98258-5779 - Phone
- (425) 330-2148
- NPI assigned
- Oct 3, 2012
- 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 | MA60235977 | WA | Primary |
Addresses
Primary practice location
9623 32ND St SE
Lake Stevens, WA 98258-5779
Mailing address
3412 97TH Dr SE
Lake Stevens, WA 98258-5728
Phone (425) 330-2148
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 |
|---|---|---|---|
| MA60235977 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389830400000",
"number": "1053663815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3412 97TH DR SE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982585728",
"telephone_number": "425-330-2148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9623 32ND ST SE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982585779",
"telephone_number": "425-330-2148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "PATRICIA",
"middle_name": "L",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-03",
"last_updated": "2014-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60235977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Stevens, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.