Individual provider Active NPI

Angela Brzoza, LMT

  • Massage Therapist
  • Mill Creek, WA
National Provider Identifier
1275191223
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60553330 Issued in WA
Practice address
805 164TH St SE Ste 102
Mill Creek, WA 98012-6316
Phone
(425) 948-7856
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA60553330 WA Primary

Addresses

Primary practice location

805 164TH St SE Ste 102
Mill Creek, WA 98012-6316

Mailing address

10417 40TH Ave SE
Everett, WA 98208-4605

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
MA60553330WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1275191223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10417 40TH AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 164TH ST SE STE 102",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126316",
            "telephone_number": "425-948-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRZOZA",
        "first_name": "ANGELA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60553330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.