Colleen Emily Peterson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61584208 Issued in WA

Practice address

447 N 1St St Ste 230
Kalama, WA 98625-9105

Phone

(360) 521-0679

NPI assigned

Oct 16, 2024

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

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": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1356161921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 LANDEN DR",
            "city": "KALAMA",
            "state": "WA",
            "postal_code": "986258918",
            "telephone_number": "360-521-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 N 1ST ST STE 230",
            "city": "KALAMA",
            "state": "WA",
            "postal_code": "986259105",
            "telephone_number": "360-521-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "COLLEEN",
        "middle_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61584208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalama Pharmacy Inc (Godfreys)
• Kalama School District
• Brenda Kaye Larson, MA
• Jeremy Levin
• Tracie Lynn Payne, RN
• Betsy Mae Preheim, LMP
• Colleen Marie Schaffer, LPN
• Spine Align Northwest P.C. (Spine Align Northwest)
• Jacob Stockton, D.C.
• Jon M Tippin, MD

• Massage Therapist in Kalama, WA
• Providers in Kalama, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.