Active NPI
Dawn Elizabeth Slack, LMT
- Massage Therapist
- Monroe, WA
National Provider Identifier
1508730433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA61229933
- Practice address
- 202 W Main St
Monroe, WA 98272-1819 - Phone
- (425) 780-7070
- NPI assigned
- Oct 2, 2025
- Last updated
- Oct 24, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT3893 | MA | |
| Massage Therapist | 225700000X | MA61229933 | WA | Primary |
Addresses
Primary practice location
202 W Main St
Monroe, WA 98272-1819
Mailing address
22225 E Lost Lake Rd
Snohomish, WA 98296-6820
Phone (617) 666-1265
Other practice location 1
15610 NE Woodinville Duvall Rd Ste 108
Woodinville, WA 98072-7069
Phone (425) 368-2003
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT3893 | MA | MD | Massage Therapist |
| MA61229933 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theta Enterprises LLC | Massage Therapist | Current | Accepting new patients |
Locations
202 W Main St
Monroe, WA 98272
Phone (425) 780-7070
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, 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": "1759363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1508730433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22225 E LOST LAKE RD",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982966820",
"telephone_number": "617-666-1265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 W MAIN ST",
"city": "MONROE",
"state": "WA",
"postal_code": "982721819",
"telephone_number": "425-780-7070"
}
],
"practiceLocations": [
{
"address_1": "15610 NE Woodinville Duvall Rd Ste 108",
"address_purpose": "LOCATION",
"city": "Woodinville",
"state": "WA",
"postal_code": "980727069",
"country_code": "US",
"telephone_number": "425-368-2003",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SLACK",
"first_name": "DAWN",
"middle_name": "ELIZABETH",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-02",
"last_updated": "2025-10-24",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MA",
"license": "MT3893",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA61229933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, WA
- Skinenvy LLC
- Anne Cathryn Skoog, LMP LICENSED MASSAGE
- Sky Valley Chiropractic Clinic P.S.
- Sky Valley Psychedelic Medical
- Sky Valley Wellness, LLC (Sky Valley Wellness)
- Chrystal Slatter, CERTIFIED PEER COUNS
- Gary O Smith, RPH
- Kristin Tomblin Smith, LMP
- Logan Donovon Smith, BS
- Michelle Christina Smith
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.