Individual provider Active NPI

Erin Mary Black, LMP

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1457412702
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00016624 Issued in WA
Practice address
9015 Holman Rd NW Ste 3
Seattle, WA 98117-3481
Phone
(206) 782-8500
Fax
(206) 784-4020
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00016624 WA Primary

Addresses

Primary practice location

9015 Holman Rd NW Ste 3
Seattle, WA 98117-3481

Mailing address

9015 Holman Rd NW Ste 3
Seattle, WA 98117-3481
Phone (206) 782-8500

Other identifiers 1

IdentifierTypeStateIssuer
0007315816OtherWAAETNA INSURANCE COMPANY

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
MA00016624WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
John S Miller, DC, Dacbr, PS Past Accepting new patients
Ballard Chiropractic Clinic, PS Massage Therapist PastSince Jan 20, 2016 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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457412702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 HOLMAN RD NW STE 3",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981173481",
            "telephone_number": "206-782-8500",
            "fax_number": "206-784-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 HOLMAN RD NW STE 3",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981173481",
            "telephone_number": "206-782-8500",
            "fax_number": "206-784-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ERIN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00016624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE COMPANY",
            "identifier": "0007315816",
            "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 Jul 8, 2007; 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.