NPIMap

Organization Active NPI

Integrated Center for Optimum Health, LLC

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1407053192
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
INTEGRATED CENTER FOR OPTIMUM HEALTH, LLC
Practice address
2505 2ND Ave Ste 100
Seattle, WA 98121
Phone
(206) 624-4020
Fax
(206) 443-3888
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Paul De Beijl, L.AC, PT
Title
Owner
Phone
(206) 623-2220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC00002074 WA
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

2505 2ND Ave Ste 100
Seattle, WA 98121

Mailing address

720 Olive Way Ste 900
Seattle, WA 98101-1840
Phone (206) 623-2220

Other identifiers 1

IdentifierTypeStateIssuer
162840OtherWAL&I GROUP #

National Provider Directory

National Provider Directory
Tax ID family
Integrated Center for Optimum Health LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1201 3rd Ave
Ste 450
Seattle, WA 98101
Phone (206) 447-2220

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1407053192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OLIVE WAY STE 900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011840",
            "telephone_number": "206-623-2220",
            "fax_number": "206-623-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 2ND AVE STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98121",
            "telephone_number": "206-624-4020",
            "fax_number": "206-443-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CENTER FOR OPTIMUM HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "DE BEIJL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-623-2220",
        "authorized_official_credential": "L.AC, PT"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00002074",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I GROUP #",
            "identifier": "162840",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.