Carrie M Burnside, LMP,LAMP
Individual provider Active NPI Massage Therapist · Duvall, WA
NPI 1124173141 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124173141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA00012914 (WA)
- Practice address
- 13130 322ND Ave NE
Duvall, WA 98019-7231 - Phone
- (206) 999-8768
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00012914 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00012914 | WA | Yes |
Addresses
Primary practice location
13130 322ND Ave NE
Duvall, WA 98019-7231
Mailing address
13130 322ND Ave NE
Duvall, WA 98019-7231
Phone (206) 999-8768
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0134645 | Other | WA | LABOR & INDUSTRIES |
Other providers in Duvall, WA
- Andrew Jerome Brown
- John Stuart Brown
- Susan Cordon Bull
- Amie Burke
- Rochelle Burns
- Amy R Bush
- Rachel Christina Byrne
- Christina Campos
- Amanda Cappelletti
- Dannelle J Carlson
All providers in Duvall, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.