Active NPI
Mira Shea, MSOM. LMT
- Massage Therapist
- Olympia, WA
National Provider Identifier
1447525860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60231148
- Practice address
- 222 Kenyon St NW Ste 13
Olympia, WA 98502-4578 - Phone
- (360) 688-4282
- NPI assigned
- Mar 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60231148 | WA | Primary |
Addresses
Primary practice location
222 Kenyon St NW Ste 13
Olympia, WA 98502-4578
Mailing address
222 Kenyon St NW Ste 13
Olympia, WA 98502-4578
Phone (360) 688-4282
Other practice location 1
1202 Black Lake Blvd. Suite E
Olympia, WA 98502
Phone (360) 688-4282
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60231148 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654992000000",
"number": "1447525860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 KENYON ST NW STE 13",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985024578",
"telephone_number": "360-688-4282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 KENYON ST NW STE 13",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985024578",
"telephone_number": "360-688-4282"
}
],
"practiceLocations": [
{
"address_1": "1202 Black Lake Blvd. Suite E",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "98502",
"country_code": "US",
"telephone_number": "360-688-4282",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEA",
"first_name": "MIRA",
"credential": "MSOM. LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-19",
"last_updated": "2022-06-12",
"certification_date": "2022-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60231148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.