Organization Active NPI

Lake Forest Park Acupuncture and Massage

  • Acupuncturist
  • Lake Forest Park, WA
National Provider Identifier
1306208830
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC60525308 Issued in WA
Legal business name
LAKE FOREST PARK ACUPUNCTURE AND MASSAGE
Practice address
18724 35TH Ave NE
Lake Forest Park, WA 98155-2602
Phone
(206) 962-7620
NPI assigned
Mar 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Authorized official

Name
Kieran McManimon, LMP
Title
Owner/Partner/Massage Therapist
Phone
(206) 962-7620

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC60525308 WA Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA60228942 WA

Addresses

Primary practice location

18724 35TH Ave NE
Lake Forest Park, WA 98155-2602

Mailing address

18724 35TH Ave NE
Lake Forest Park, WA 98155-2602
Phone (206) 962-7620

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1306208830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18724 35TH AVE NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981552602",
            "telephone_number": "206-962-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18724 35TH AVE NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981552602",
            "telephone_number": "206-962-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FOREST PARK ACUPUNCTURE AND MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "MCMANIMON",
        "authorized_official_first_name": "KIERAN",
        "authorized_official_title_or_position": "OWNER/PARTNER/MASSAGE THERAPIST",
        "authorized_official_telephone_number": "206-962-7620",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60525308",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60228942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest Park, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.