Individual provider Active NPI

Ann Wagner, L.M.P.

  • Massage Therapist
  • Lynnwood, WA
National Provider Identifier
1386815512
Registry record updated Mar 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MAOOO24020 Issued in WA
Practice address
16303 Highway 99 Ste 1a
Lynnwood, WA 98087-1453
Phone
(425) 876-5721
Fax
(425) 743-9409
NPI assigned
Mar 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2008

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 MAOOO24020 WA Primary

Addresses

Primary practice location

16303 Highway 99 Ste 1a
Lynnwood, WA 98087-1453

Mailing address

16303 Highway 99 Ste 1a
Lynnwood, WA 98087-1453
Phone (425) 876-5721

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
MAOOO24020WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1205539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205539200000",
    "number": "1386815512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16303 HIGHWAY 99 STE 1A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871453",
            "telephone_number": "425-876-5721",
            "fax_number": "425-743-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16303 HIGHWAY 99 STE 1A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871453",
            "telephone_number": "425-876-5721",
            "fax_number": "425-743-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-15",
        "last_updated": "2008-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MAOOO24020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2008; 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.