Individual provider Active NPI

Aidan Sievertson, LMT

  • Massage Therapist
  • Bainbridge Island, WA
National Provider Identifier
1306483664
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60984186 Issued in WA
Practice address
931 Hildebrand LN NE Ste 101
Bainbridge Island, WA 98110-2823
Phone
(206) 842-2690
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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 MA60984186 WA Primary

Addresses

Primary practice location

931 Hildebrand LN NE Ste 101
Bainbridge Island, WA 98110-2823

Mailing address

4075 NE Little Hill Way
Poulsbo, WA 98370-8677
Phone (206) 861-5323

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
MA60984186WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Harbor Health & Chiropractic CurrentSince Oct 4, 2020 Accepting new patients

Locations

931 Hildebrand Ln NE
#101
Bainbridge Island, WA 98110
Phone (206) 842-2690

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1306483664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 NE LITTLE HILL WAY",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708677",
            "telephone_number": "206-861-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 HILDEBRAND LN NE STE 101",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102823",
            "telephone_number": "206-842-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEVERTSON",
        "first_name": "AIDAN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60984186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.