Mitzi Gayle Lawson, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00007462 Issued in WA

Practice address

1790 Sidney Ave
# 8-331
Port Orchard, WA 98366-2439

Phone

(360) 649-8419

NPI assigned

Nov 20, 2009

Last updated

Nov 20, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1205164746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 SIDNEY AVE",
            "address_2": "# 8-331",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662439",
            "telephone_number": "360-649-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 SIDNEY AVE",
            "address_2": "# 8-331",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662439",
            "telephone_number": "360-649-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "MITZI",
        "middle_name": "GAYLE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00007462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MASSAGE PRACTITIONER",
            "identifier": "MA00007462",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.