Stephanie Lynn Pederson, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60250922 Issued in WA

Practice address

601 S Pine St Ste 201
Tacoma, WA 98405-2795

Phone

(253) 396-1000

NPI assigned

Dec 1, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• E1Spine PLLC

  dba Ballard Seattle Chiropractic Center

  • Chiropractor
  • Seattle, WA
  • NPI 1780207241

  Massage Therapist

  NPD (past)
• Tacoma Chiropractic Health Connection

  dba The Health Connection

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1568595098
  NPD (past)

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1225306541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N K ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984031830",
            "telephone_number": "253-973-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S PINE ST STE 201",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052795",
            "telephone_number": "253-396-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60250922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Daniel Pecsok, MD
• Ashley Pedde
• Chris John Pederson
• Jonathan Pederson, DO
• Sarah Anne Pederson
• John Patrick Pedey-Braswell, PHARMD, BCPP, BCPS
• Pediatric Dental Care Center
• Pediatric Neurology Associates PS
• Pediatrics Northwest PS
• Pediatrix Cardiology of Washington, P.C.

• Massage Therapist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.