Individual provider Active NPI

Llysa Marie Holland, LMP

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1093013047
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00005597 Issued in WA
Practice address
315 1St Ave W Ste a
Seattle, WA 98119-4134
Phone
(206) 784-8647
Fax
(206) 285-6854
NPI assigned
Feb 28, 2011
Last updated
Nov 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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 MA00005597 WA Primary

Addresses

Primary practice location

315 1St Ave W Ste a
Seattle, WA 98119-4134

Mailing address

1620 SW Trenton St
Seattle, WA 98106-2343
Phone (206) 784-8647

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
MA00005597WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Clinics, PLLC Past Accepting new patients
Queen Anne Naturopathic Center LTD PastSince Nov 10, 2019 Accepting new patients
Starr Chiropractic, P.S. Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1093013047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 SW TRENTON ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981062343",
            "telephone_number": "206-784-8647",
            "fax_number": "206-281-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 1ST AVE W STE A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981194134",
            "telephone_number": "206-784-8647",
            "fax_number": "206-285-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "LLYSA",
        "middle_name": "MARIE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-28",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00005597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.