Individual provider Active NPI

Cindy Costa, LMP

  • Specialist
  • Snoqualmie, WA
National Provider Identifier
1194271718
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
00005988 Issued in WA
Practice address
38579 SE River Street
Suite 13
Snoqualmie, WA 98065
Phone
(425) 208-5048
NPI assigned
Sep 1, 2016
Last updated
Sep 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 00005988 WA Primary

Addresses

Primary practice location

38579 SE River Street
Suite 13
Snoqualmie, WA 98065

Mailing address

PO Box 2355
North Bend, WA 98045-2355
Phone (425) 894-1015

Other identifiers 1

IdentifierTypeStateIssuer
00005988OtherWAMASSAGE LISCENSE

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
00005988WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1194271718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2355",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980452355",
            "telephone_number": "425-894-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38579 SE RIVER STREET",
            "address_2": "SUITE 13",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "98065",
            "telephone_number": "425-208-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "CINDY",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "00005988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LISCENSE",
            "identifier": "00005988",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snoqualmie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.