Individual provider Active NPI

Emily Lisa Rose, LMT

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1477126936
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61182762 Issued in WA
Practice address
2719 E Madison St Ste 203
Seattle, WA 98112-4752
Phone
(206) 568-7545
NPI assigned
Jul 22, 2021
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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 MA61182762 WA Primary

Addresses

Primary practice location

2719 E Madison St Ste 203
Seattle, WA 98112-4752

Mailing address

108 N 46TH St
Seattle, WA 98103-6307
Phone (614) 738-6806

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Jane Glow Natural Health

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
MA61182762WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heather L .Bergfors DC PS CurrentSince Jul 25, 2021 Accepting new patients
Treehouse Ventures NW, Inc Massage Therapist PastSince Jul 25, 2021 Accepting new patients

Locations

2719 E Madison St
Ste 203
Seattle, WA 98112
Phone (206) 568-7545

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1477126936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N 46TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036307",
            "telephone_number": "614-738-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 E MADISON ST STE 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124752",
            "telephone_number": "206-568-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "EMILY",
        "middle_name": "LISA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61182762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Jane",
            "affiliation": "Y",
            "endpointDescription": "Electronic Health Record Keeper for Charting",
            "affiliationName": "Glow Natural Health",
            "address_1": "2719 E Madison St Ste 203",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981124752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 22, 2021; 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.