Individual provider Active NPI

Leia Duckworth, LMP

  • Massage Therapist
  • Redmond, WA
National Provider Identifier
1194055889
Registry record updated Jan 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00011638 Issued in WA
Practice address
15965 NE 85TH St Ste 102
Redmond, WA 98052-3593
Phone
(425) 882-9065
Fax
(425) 558-1900
NPI assigned
Jan 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 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 MA00011638 WA Primary

Addresses

Primary practice location

15965 NE 85TH St Ste 102
Redmond, WA 98052-3593

Mailing address

15965 NE 85TH St Ste 102
Redmond, WA 98052-3593
Phone (425) 882-9065

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
MA00011638WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1262476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262476800000",
    "number": "1194055889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15965 NE 85TH ST STE 102",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523593",
            "telephone_number": "425-882-9065",
            "fax_number": "425-558-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15965 NE 85TH ST STE 102",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523593",
            "telephone_number": "425-882-9065",
            "fax_number": "425-558-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "LEIA",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-03",
        "last_updated": "2010-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00011638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.