NPIMap

Organization Active NPI

Serenity Medical Massage & Bodywork LLC

  • Specialist
  • Duvall, WA
National Provider Identifier
1215470281
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00010003 Issued in WA
Legal business name
SERENITY MEDICAL MASSAGE & BODYWORK LLC
Practice address
15315 1St Ave NE
Duvall, WA 98019-6339
Phone
(425) 788-0505
Fax
(425) 788-3340
NPI assigned
Nov 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Authorized official

Name
Ms. Jody M Bickle, LMTNPI 1760516132
Title
Owner
Phone
(253) 232-6377

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA00010003 WA Primary

Addresses

Primary practice location

15315 1St Ave NE
Duvall, WA 98019-6339

Mailing address

24121 NE 140TH St
Woodinville, WA 98077-7281
Phone (425) 788-0505

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1215470281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24121 NE 140TH ST",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980777281",
            "telephone_number": "425-788-0505",
            "fax_number": "425-788-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15315 1ST AVE NE",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980196339",
            "telephone_number": "425-788-0505",
            "fax_number": "425-788-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY MEDICAL MASSAGE & BODYWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "BICKLE",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-232-6377",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00010003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duvall, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.