Individual provider Active NPI

Niki De Sario, LMP

  • Massage Therapist
  • Bellevue, WA
National Provider Identifier
1417190208
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00009705 Issued in WA
Practice address
13622 NE 20TH St
Suite a
Bellevue, WA 98005-4900
Phone
(425) 444-3115
NPI assigned
Apr 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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 MA00009705 WA Primary

Addresses

Primary practice location

13622 NE 20TH St
Suite a
Bellevue, WA 98005-4900

Mailing address

9811 NE 124TH St Apt 405
Kirkland, WA 98034-3744
Phone (425) 444-3115

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
MA00009705WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1417190208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 NE 124TH ST APT 405",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343744",
            "telephone_number": "425-444-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13622 NE 20TH ST",
            "address_2": "SUITE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980054900",
            "telephone_number": "425-444-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SARIO",
        "first_name": "NIKI",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00009705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.