NPIMap

Organization Active NPI

Serene Lake Massage Therapy

  • Specialist
  • Lynnwood, WA
National Provider Identifier
1619003316
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MAOOO10193 Issued in WA
Legal business name
SERENE LAKE MASSAGE THERAPY
Practice address
3501 Shelby Rd
Suite C
Lynnwood, WA 98087-3599
Phone
(425) 745-9052
Fax
(425) 745-3372
NPI assigned
Feb 26, 2007
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Chad Eric Triplett, LMPNPI 1346398823
Title
President
Phone
(425) 745-9052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MAOOO10193 WA Primary

Addresses

Primary practice location

3501 Shelby Rd
Suite C
Lynnwood, WA 98087-3599

Mailing address

3501 Shelby Rd
Suite C
Lynnwood, WA 98087-3599
Phone (425) 745-9052

National Provider Directory

National Provider Directory
Tax ID family
Serene Lake Massage Therapy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3501 Shelby Rd
Ste C
Lynnwood, WA 98087
Phone (425) 745-9052

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1619003316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SHELBY RD",
            "address_2": "SUITE C",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980873599",
            "telephone_number": "425-745-9052",
            "fax_number": "425-745-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SHELBY RD",
            "address_2": "SUITE C",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980873599",
            "telephone_number": "425-745-9052",
            "fax_number": "425-745-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE LAKE MASSAGE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "TRIPLETT",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-745-9052",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MAOOO10193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.