Individual provider Active NPI

Susan R Cole, L.M.P.

  • Massage Therapist
  • Everett, WA
National Provider Identifier
1447684246
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60406978 Issued in WA
Practice address
2205 Wall St
Everett, WA 98201-3761
Phone
(425) 512-8695
NPI assigned
Aug 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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 MA60406978 WA Primary

Addresses

Primary practice location

2205 Wall St
Everett, WA 98201-3761

Mailing address

21910 99TH Ave SE
Snohomish, WA 98296-4923
Phone (206) 948-6677

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
MA60406978WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Engineered Sports 2 PLLC PastSince Dec 6, 2020 Accepting new patients
Kent Physical Therapy & Sports Performance Center LLC PastSince Aug 1, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1447684246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21910 99TH AVE SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982964923",
            "telephone_number": "206-948-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 WALL ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013761",
            "telephone_number": "425-512-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "SUSAN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60406978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.