Mollie Ann Fonceca

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00024274 Issued in WA

Practice address

815 103Rd Dr SE
Lake Stevens, WA 98258-9458

Phone

(425) 334-9287

NPI assigned

Jul 12, 2007

Last updated

Jul 12, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1649479437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 103RD DR SE",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982589458",
            "telephone_number": "425-334-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 103RD DR SE",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982589458",
            "telephone_number": "425-334-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONCECA",
        "first_name": "MOLLIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Lake Stevens, WA
• Providers in Lake Stevens, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.