Individual provider Active NPI

Mari Linda Ellingsen, DC LMP

  • Massage Therapist
  • Bainbridge Island, WA
National Provider Identifier
1396952040
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
6782 Issued in WA
Practice address
2 On the Square
Bainbridge Island, WA 98110
Phone
(206) 842-6688
Fax
(206) 842-6689
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3265 WA
Massage Therapist 225700000X 6782 WA Primary

Addresses

Primary practice location

2 On the Square
Bainbridge Island, WA 98110

Mailing address

2 On the Square
Bainbridge Island, WA 98110
Phone (206) 842-6688

Other identifiers 5

IdentifierTypeStateIssuer
109378OtherDEPARTMENT OF LABOR AND
5001404OtherAETNA
911736082EL6082OtherREGENCE BLUE SHIELD
1306020OtherHIGHMARK BLUE SHIELD
653335OtherACN GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100506000209 WA Practitioner - Chiropractic 3678601036 Practice locations: Bainbridge Island, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

265 Winslow Way
Suite 2
Bainbridge Island, WA 98110-2462

265 Winslow Way E
Bainbridge Island, WA 98110-2462
Phone (206) 842-6688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3265WAMDChiropractor
6782WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1396952040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ON THE SQUARE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-842-6688",
            "fax_number": "206-842-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ON THE SQUARE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-842-6688",
            "fax_number": "206-842-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSEN",
        "first_name": "MARI",
        "middle_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "DC LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "3265",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "6782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR AND",
            "identifier": "109378",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5001404",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "911736082EL6082",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1306020",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP",
            "identifier": "653335",
            "state": null
        }
    ],
    "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 Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.