Deedra Ann Simonelli, MA60228974

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60228974 Issued in WA

Practice address

16825 48TH Ave W Ste 243
Lynnwood, WA 98037-6406

Phone

(206) 533-3348

NPI assigned

Mar 10, 2021

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

Electronic endpoints 1

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": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1275118481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18705 126TH AVE NE APT 2703",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980119349",
            "telephone_number": "206-533-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16825 48TH AVE W STE 243",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980376406",
            "telephone_number": "206-533-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONELLI",
        "first_name": "DEEDRA",
        "middle_name": "ANN",
        "credential": "MA60228974",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60228974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "deedramassagespa.com",
            "affiliation": "N",
            "endpointDescription": "massage therapy/medical massage",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "deedramassagespa.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "esthetics",
            "address_1": "16825 48th Ave W Ste 243",
            "city": "Lynnwood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980376406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel Mark Silvermint, MA
• John J Sim, DC
• Morgan Simkins
• Joan S Simon Oncken, LMFT
• Taylor Simon
• Susan Simons, PTA
• Katlyn Leigh Simonsen
• Dawn Mary Simpson
• Edgar Allan Sinfuego, MS, MA
• Deborah Singer

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.