Active NPI
Michelle Elaine Vanderway, LMP
- Massage Therapist
- Marysville, WA
National Provider Identifier
1114143476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00022203
- Practice address
- 1052 State Ave
Marysville, WA 98270 - Phone
- (206) 679-7372
- Fax
- (425) 397-6179
- NPI assigned
- Apr 17, 2007
- 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 | MA00022203 | WA | Primary |
Addresses
Primary practice location
1052 State Ave
Marysville, WA 98270
Mailing address
PO Box 842
Marysville, WA 98270-0842
Phone (206) 679-7372
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 |
|---|---|---|---|
| MA00022203 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536278400000",
"number": "1114143476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 842",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982700842",
"telephone_number": "206-679-7372",
"fax_number": "425-397-6179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1052 STATE AVE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "98270",
"telephone_number": "206-679-7372",
"fax_number": "425-397-6179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERWAY",
"first_name": "MICHELLE",
"middle_name": "ELAINE",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2018-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00022203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.