Emerald Vine PLLC

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

MA00025243 Issued in WA

Legal business name

EMERALD VINE PLLC

Practice address

142 NW Canal St
Seattle, WA 98107-4933

Phone

(206) 347-0777

Fax

(888) 254-3281

NPI assigned

Feb 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Shaina Mariko Akidau, LMP

Title

Owner

Phone

(206) 347-0777

Specialties & licenses 1

Addresses

Other names 1

• Emerald Vine Massage Doing business as

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235088000000",
    "number": "1104066836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 NW CANAL ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074933",
            "telephone_number": "206-347-0777",
            "fax_number": "888-254-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 NW CANAL ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074933",
            "telephone_number": "206-347-0777",
            "fax_number": "888-254-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD VINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-02-20",
        "status": "A",
        "authorized_official_last_name": "AKIDAU",
        "authorized_official_first_name": "SHAINA",
        "authorized_official_middle_name": "MARIKO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-347-0777",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mechanotherapist",
            "state": "WA",
            "license": "MA00025243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Vine Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mechanotherapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Mechanotherapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.