Individual provider Active NPI

Leah Marie Ivanoff, LMP

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1598099012
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00020112 Issued in WA
Practice address
3703 California Ave SW
Suite a
Seattle, WA 98116-3771
Phone
(206) 937-3965
Fax
(206) 937-4695
NPI assigned
Sep 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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 MA00020112 WA Primary

Addresses

Primary practice location

3703 California Ave SW
Suite a
Seattle, WA 98116-3771

Mailing address

3703 California Ave SW
Suite a
Seattle, WA 98116-3771
Phone (206) 937-3965

Other identifiers 1

IdentifierTypeStateIssuer
MA00020112OtherWAWASHINGTON STATE DEPARTMENT OF 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
MA00020112WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Swanson & Seepersad Chiropractic, P.S. PastSince Nov 22, 2009 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": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1598099012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 CALIFORNIA AVE SW",
            "address_2": "SUITE A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163771",
            "telephone_number": "206-937-3965",
            "fax_number": "206-937-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 CALIFORNIA AVE SW",
            "address_2": "SUITE A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163771",
            "telephone_number": "206-937-3965",
            "fax_number": "206-937-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOFF",
        "first_name": "LEAH",
        "middle_name": "MARIE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00020112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "MA00020112",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "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 Sep 30, 2009; 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.