Athena Peterson, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00023839 Issued in WA

Practice address

23100 Pacific Hwy S
Ste 201
Des Moines, WA 98198-7281

Phone

(206) 824-9500

Fax

(206) 824-9654

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Athena Bower Former name

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1326266560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23100 PACIFIC HWY S",
            "address_2": "STE 201",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987281",
            "telephone_number": "206-824-9500",
            "fax_number": "206-824-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 PACIFIC HWY S",
            "address_2": "STE 201",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987281",
            "telephone_number": "206-824-9500",
            "fax_number": "206-824-9654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ATHENA",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ATHENA",
            "last_name": "BOWER",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Massage Therapist in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.