Individual provider Active NPI

Wendy C Stockton, LMP

  • Specialist
  • Lynnwood, WA
National Provider Identifier
1467667402
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00015991 Issued in WA
Practice address
3501 Shelby Rd Ste C
Lynnwood, WA 98087-3599
Phone
(425) 745-9052
Fax
(425) 745-3372
NPI assigned
May 12, 2007
Sex
Female
Sole proprietor
No

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
Specialist 174400000X MA00015991 WA Primary

Addresses

Primary practice location

3501 Shelby Rd Ste C
Lynnwood, WA 98087-3599

Mailing address

12402 Admiralty Way Apt H103
Everett, WA 98204-8558
Phone (206) 719-0452

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
MA00015991WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Lake Massage Therapy Specialist Past Accepting new patients

Organizations & group practices 1

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": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467667402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12402 ADMIRALTY WAY APT H103",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982048558",
            "telephone_number": "206-719-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SHELBY RD STE C",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980873599",
            "telephone_number": "425-745-9052",
            "fax_number": "425-745-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKTON",
        "first_name": "WENDY",
        "middle_name": "C",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00015991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, 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.