Individual provider Active NPI

Susan Laurie McNelis, LMP

  • Massage Therapist
  • Redmond, WA
National Provider Identifier
1497946214
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00011231 Issued in WA
Practice address
6404 E Lake Sammamish Pkwy NE Apt 302
Redmond, WA 98052-6152
Phone
(425) 558-4449
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 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 MA00011231 WA Primary

Addresses

Primary practice location

6404 E Lake Sammamish Pkwy NE Apt 302
Redmond, WA 98052-6152

Mailing address

6404 E Lake Sammamish Pkwy NE Apt 302
Redmond, WA 98052-6152
Phone (425) 558-4449

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
MA00011231WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1497946214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 E LAKE SAMMAMISH PKWY NE APT 302",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980526152",
            "telephone_number": "425-558-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 E LAKE SAMMAMISH PKWY NE APT 302",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980526152",
            "telephone_number": "425-558-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNELIS",
        "first_name": "SUSAN",
        "middle_name": "LAURIE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00011231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.