NPIMap

Individual provider Active NPI

Amanda Regina Holland, LMP

  • Massage Therapist
  • Lynnwood, WA
National Provider Identifier
1093170664
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60620250 Issued in WA
Practice address
20833 67TH Ave W
Suite 301
Lynnwood, WA 98036-7365
Phone
(425) 697-0823
NPI assigned
Dec 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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 MA60620250 WA Primary

Addresses

Primary practice location

20833 67TH Ave W
Suite 301
Lynnwood, WA 98036-7365

Mailing address

18600 52ND Ave W
Apt. B106
Lynnwood, WA 98037-4590
Phone (425) 931-1273

Other names 1

  • Amanda Regina Isaak Former name

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
MA60620250WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Treat Yourself Day Spa Massage Therapist Past Accepting new patients

Organizations & group practices 1

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1093170664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18600 52ND AVE W",
            "address_2": "APT. B106",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374590",
            "telephone_number": "425-931-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20833 67TH AVE W",
            "address_2": "SUITE 301",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367365",
            "telephone_number": "425-697-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "AMANDA",
        "middle_name": "REGINA",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60620250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ISAAK",
            "middle_name": "REGINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.