Individual provider Active NPI

Lacey Nicole Engelmann, LMP

  • Massage Therapist
  • Longview, WA
National Provider Identifier
1508160284
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60111043 Issued in WA
Practice address
1560 3Rd Ave
Longview, WA 98632-3229
Phone
(360) 423-9535
NPI assigned
Jan 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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 MA60111043 WA Primary

Addresses

Primary practice location

1560 3Rd Ave
Longview, WA 98632-3229

Mailing address

1560 3Rd Ave
Longview, WA 98632-3229
Phone (360) 423-9535

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
MA60111043WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1508160284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 3RD AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323229",
            "telephone_number": "360-423-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 3RD AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323229",
            "telephone_number": "360-423-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELMANN",
        "first_name": "LACEY",
        "middle_name": "NICOLE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60111043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.