Michele Adelaide Wyzga, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00024674 Issued in WA

Practice address

9445 NE Business Park LN
Ste 203
Bainbridge Is, WA 98110-4634

Phone

(206) 290-8900

NPI assigned

Jan 5, 2010

Last updated

Jan 5, 2010By 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

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": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1255661849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6822 NE BERGMAN RD",
            "city": "BAINBRIDGE IS",
            "state": "WA",
            "postal_code": "981101285",
            "telephone_number": "206-290-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9445 NE BUSINESS PARK LN",
            "address_2": "STE 203",
            "city": "BAINBRIDGE IS",
            "state": "WA",
            "postal_code": "981104634",
            "telephone_number": "206-290-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYZGA",
        "first_name": "MICHELE",
        "middle_name": "ADELAIDE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahid Mohamed Sahid
• Gloria W Sayler, M.S.S., LICSW
• Kristine K Stapleton, LMP
• Washington State Smile Partners
• Laura Wulff, MD

• Massage Therapist in Bainbridge Is, WA
• Providers in Bainbridge Is, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.