Individual provider Active NPI

Michael J Mandell, LMP

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1659419711
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00019519 Issued in WA
Practice address
1709 Harbor Ave SW
Suite 100
Seattle, WA 98126-2049
Phone
(206) 535-2873
Fax
(206) 455-9184
NPI assigned
Feb 2, 2007
Last updated
Dec 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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 MA00019519 WA Primary

Addresses

Primary practice location

1709 Harbor Ave SW
Suite 100
Seattle, WA 98126-2049

Mailing address

4701 SW Admiral Way
Suite 18
Seattle, WA 98116-2340
Phone (206) 535-2873

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
MA00019519WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1659419711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 SW ADMIRAL WAY",
            "address_2": "SUITE 18",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981162340",
            "telephone_number": "206-535-2873",
            "fax_number": "206-455-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 HARBOR AVE SW",
            "address_2": "SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981262049",
            "telephone_number": "206-535-2873",
            "fax_number": "206-455-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELL",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00019519",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 1, 2015; 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.