Individual provider Active NPI

Loretta S Dellon, LMP

  • Massage Therapist
  • Shoreline, WA
National Provider Identifier
1265623243
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00020171 Issued in WA
Practice address
17034 Aurora Ave N
Suite D
Shoreline, WA 98133-5345
Phone
(206) 251-6640
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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 MA00020171 WA Primary

Addresses

Primary practice location

17034 Aurora Ave N
Suite D
Shoreline, WA 98133-5345

Mailing address

17034 Aurora Ave N
Suite D
Shoreline, WA 98133-5345
Phone (206) 251-6640

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
MA00020171WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1265623243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17034 AURORA AVE N",
            "address_2": "SUITE D",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335345",
            "telephone_number": "206-251-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17034 AURORA AVE N",
            "address_2": "SUITE D",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335345",
            "telephone_number": "206-251-6640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLON",
        "first_name": "LORETTA",
        "middle_name": "S",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00020171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.