Active NPI
Michelle Rene Roberts, LMP
- Massage Therapist
- Bellevue, WA
National Provider Identifier
1164733077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60142021
- Practice address
- 10620 NE 8TH St
Suite 201
Bellevue, WA 98004-4380 - Phone
- (425) 999-9633
- NPI assigned
- Jun 24, 2010
- Last updated
- Jun 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | MA60142021 | WA | Primary |
Addresses
Primary practice location
10620 NE 8TH St
Suite 201
Bellevue, WA 98004-4380
Mailing address
10620 NE 8TH St
Suite 201
Bellevue, WA 98004-4380
Phone (425) 999-9633
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 |
|---|---|---|---|
| MA60142021 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Master Group LLC | Past | Accepting new patients | |
| Pacific Coast Medical Group | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277337600000",
"number": "1164733077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10620 NE 8TH ST",
"address_2": "SUITE 201",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980044380",
"telephone_number": "425-999-9633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10620 NE 8TH ST",
"address_2": "SUITE 201",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980044380",
"telephone_number": "425-999-9633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MICHELLE",
"middle_name": "RENE",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-24",
"last_updated": "2010-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60142021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.