Individual provider Active NPI

Abby Cicirelli, LMP

  • Massage Therapist
  • Edmonds, WA
National Provider Identifier
1255569869
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA#00004012 Issued in WA
Practice address
12326 Possession LN
Edmonds, WA 98026-3147
Phone
(425) 319-9588
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA#00004012 WA Primary

Addresses

Primary practice location

12326 Possession LN
Edmonds, WA 98026-3147

Mailing address

2615 W Casino Rd Ste 1a
Everett, WA 98204-2109
Phone (425) 319-9588

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
MA#00004012WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1255569869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 W CASINO RD STE 1A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042109",
            "telephone_number": "425-319-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12326 POSSESSION LN",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980263147",
            "telephone_number": "425-319-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICIRELLI",
        "first_name": "ABBY",
        "name_prefix": "Miss",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA#00004012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

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