Judy Lee Elder, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00023165 Issued in WA

Practice address

25 - 95Dr. NE
Suite 105
Lake Stevens, WA 98258

Phone

(425) 334-9137

Fax

(425) 377-9487

NPI assigned

May 25, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lake Stevens Massage Therapy, Inc.

  • Massage Therapist
  • Lake Stevens, WA
  • NPI 1821603291
  NPD (past)
• Shanlee Stephens

  • Massage Therapist
  • Lake Stevens, WA
  • NPI 1609243740
  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295946705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 103RD AVE SE",
            "address_2": "B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982053113",
            "telephone_number": "425-334-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 - 95DR. NE",
            "address_2": "SUITE 105",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "98258",
            "telephone_number": "425-334-9137",
            "fax_number": "425-377-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "JUDY",
        "middle_name": "LEE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE PRACTITIONER",
            "identifier": "MA00023165",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyman Charles Drown, ATC
• Edmark Chiropractic PLLC
• Kurt A Edmark, D.C.
• Esther Edwards
• Sidney Marion Elder-Hammond
• Elite Sleep Supplies, LLC
• Elite Sleep, LLC
• Erin Elofson
• Thomas Stillman Elsemore, CRNA
• Empowered Physical Therapy PLLC

• Massage Therapist in Lake Stevens, WA
• Providers in Lake Stevens, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.