Individual provider Active NPI

Lynette Jean Miller, LMP

  • Massage Therapist
  • Yakima, WA
National Provider Identifier
1164601654
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00024761 Issued in WA
Practice address
111 South 3Rd Street
Yakima, WA 98901
Phone
(509) 249-8704
Fax
(509) 249-8706
NPI assigned
Oct 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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 MA00024761 WA Primary

Addresses

Primary practice location

111 South 3Rd Street
Yakima, WA 98901

Mailing address

111 South 3Rd Street
Yakima, WA 98901
Phone (509) 249-8704

Other names 1

  • Ms. Lynette Jean Miller 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
MA00024761WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
RPM Rehab, Inc Massage Therapist PastSince Nov 4, 2011 Accepting new patients
Cascade Summit Physical Therapy Inc PS Past Accepting new patients

Organizations & group practices 2

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": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1164601654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SOUTH 3RD STREET",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98901",
            "telephone_number": "509-249-8704",
            "fax_number": "509-249-8706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SOUTH 3RD STREET",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98901",
            "telephone_number": "509-249-8704",
            "fax_number": "509-249-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LYNETTE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNETTE",
            "last_name": "MILLER",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.