Active NPI
Stephanie Ahern, LMP
- Massage Therapist
- Bonney Lake, WA
National Provider Identifier
1194841262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00016830
- Practice address
- 22015 State Route 410 E
Bonney Lake, WA 98391-4241 - Phone
- (253) 891-9109
- Fax
- (253) 826-0438
- NPI assigned
- Mar 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 | MA00016830 | WA | Primary |
Addresses
Primary practice location
22015 State Route 410 E
Bonney Lake, WA 98391-4241
Mailing address
20504 123Rd Street CT E
Bonney Lake, WA 98391-7448
Phone (253) 862-3186
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0163130 | Other | WA | W.C. & L&I NUMBER |
| 0210469 | Other | WA | W.C. & L&I NUMBER |
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 |
|---|---|---|---|
| MA00016830 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paradigm Chiropractic PLLC | Past | Accepting new patients | |
| Sunset Chiropractic & Wellness Center. Inc | 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.
-
- Chiropractor
- Bonney Lake, WA
- NPI 1205113370
-
- Chiropractor
- Bonney Lake, WA
- NPI 1679698278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194841262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20504 123RD STREET CT E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983917448",
"telephone_number": "253-862-3186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22015 STATE ROUTE 410 E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983914241",
"telephone_number": "253-891-9109",
"fax_number": "253-826-0438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHERN",
"first_name": "STEPHANIE",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00016830",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "W.C. & L&I NUMBER",
"identifier": "0163130",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "W.C. & L&I NUMBER",
"identifier": "0210469",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.