Individual provider Active NPI

Lydia Lucia Harris, LMP, CYT

  • Massage Therapist
  • Olympia, WA
National Provider Identifier
1164685939
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00024230 Issued in WA
Practice address
1015 4TH Ave W
Suite G
Olympia, WA 98502-5467
Phone
(360) 359-3460
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00024230 WA Primary
Massage Therapist 225700000X 11923 OR

Addresses

Primary practice location

1015 4TH Ave W
Suite G
Olympia, WA 98502-5467

Mailing address

502 Milroy St NW
Apt a
Olympia, WA 98502-0604
Phone (360) 359-3460

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
11923ORMDMassage Therapist
MA00024230WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1164685939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MILROY ST NW",
            "address_2": "APT A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985020604",
            "telephone_number": "360-359-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 4TH AVE W",
            "address_2": "SUITE G",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025467",
            "telephone_number": "360-359-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LYDIA",
        "middle_name": "LUCIA",
        "name_prefix": "Miss",
        "credential": "LMP, CYT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024230",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "11923",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.