NPIMap

Organization Active NPI

Body Recovery Clinic LLC

  • Massage Therapist
  • Lynnwood, WA
National Provider Identifier
1649492687
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00010258 Issued in WA
Legal business name
BODY RECOVERY CLINIC LLC
Practice address
19410 36TH Ave W Ste 9
Lynnwood, WA 98036-5747
Phone
(425) 670-0970
Fax
(425) 670-0940
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Shawna Vansickle
Title
Manager
Phone
(425) 670-0970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA00010258 WA Primary

Addresses

Primary practice location

19410 36TH Ave W Ste 9
Lynnwood, WA 98036-5747

Mailing address

19410 36TH Ave W Ste 9
Lynnwood, WA 98036-5747
Phone (425) 670-0970

National Provider Directory

National Provider Directory

Locations

19410 36th Ave W
Ste 9
Lynnwood, WA 98036
Phone (425) 670-0970

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1649492687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19410 36TH AVE W STE 9",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365747",
            "telephone_number": "425-670-0970",
            "fax_number": "425-670-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19410 36TH AVE W STE 9",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365747",
            "telephone_number": "425-670-0970",
            "fax_number": "425-670-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY RECOVERY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "VANSICKLE",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "425-670-0970"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00010258",
            "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 Jul 19, 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.