Still Waters Therapeutic PLLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00015674 Issued in WA

Legal business name

STILL WATERS THERAPEUTIC PLLC

Practice address

22000 Marine View Dr So Suite 202
Des Moines, WA 98198

Phone

(206) 235-1958

Fax

(206) 235-1958

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Leslie Anne Mathe Sivret, LMP

Title

Owner Manager

Phone

(206) 235-1958

Specialties & licenses 1

Addresses

Other names 1

• Limited Liability Company Other name

Locations

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1457565327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22000 MARINE VIEW DR SO SUITE 202",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "98198",
            "telephone_number": "206-235-1958",
            "fax_number": "206-824-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22000 MARINE VIEW DR SO SUITE 202",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "98198",
            "telephone_number": "206-235-1958",
            "fax_number": "206-235-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS THERAPEUTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "SIVRET",
        "authorized_official_first_name": "LESLIE ANNE",
        "authorized_official_middle_name": "MATHE",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "206-235-1958",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00015674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Limited Liability Company",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Massage Therapist in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.