Organization Active NPI

Lighthouse Natural Medicine, PLLC

  • Non-Pharmacy Dispensing Site
  • Mukilteo, WA
National Provider Identifier
1407201569
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
NT00001592 Issued in WA
Legal business name
LIGHTHOUSE NATURAL MEDICINE, PLLC
Practice address
117 Park Ave
Mukilteo, WA 98275-1619
Phone
(425) 789-1779
Fax
(888) 431-8819
NPI assigned
Apr 26, 2016
Organization subpart
Yes
Parent organization
LIGHTHOUSE NATURAL MEDICINE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Authorized official

Name
Maegan Knutson, ND
Title
Owner
Phone
(425) 789-1779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NT00001592 WA Primary

Addresses

Primary practice location

117 Park Ave
Mukilteo, WA 98275-1619

Mailing address

2980 N Beverly Glen Cir
Suite 100
Los Angeles, CA 90077-1726
Phone (310) 943-4180

National Provider Directory

National Provider Directory
Part of
Lighthouse Natural Medicine PLLC

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26114/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1407201569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-943-4180",
            "fax_number": "888-431-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 PARK AVE",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982751619",
            "telephone_number": "425-789-1779",
            "fax_number": "888-431-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE NATURAL MEDICINE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIGHTHOUSE NATURAL MEDICINE, PLLC",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "KNUTSON",
        "authorized_official_first_name": "MAEGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-789-1779",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "WA",
            "license": "NT00001592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.