Individual provider Active NPI

Paige Linder Pattillo, LMP

  • Massage Therapist
  • Bothell, WA
National Provider Identifier
1053853085
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
60580744 Issued in WA
Practice address
21715 49TH Ave SE
Bothell, WA 98021-8042
Phone
(206) 818-5611
NPI assigned
Nov 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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 60580744 WA Primary

Addresses

Primary practice location

21715 49TH Ave SE
Bothell, WA 98021-8042

Mailing address

21715 49TH Ave SE
Bothell, WA 98021-8042
Phone (206) 818-5611

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
60580744WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1053853085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21715 49TH AVE SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218042",
            "telephone_number": "206-818-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21715 49TH AVE SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218042",
            "telephone_number": "206-818-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTILLO",
        "first_name": "PAIGE",
        "middle_name": "LINDER",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60580744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.