Active NPI
Clementine Marie, LMT
- Massage Therapist
- Seattle, WA
National Provider Identifier
1669868782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60524067
- Practice address
- 5963 SW Carroll St
Seattle, WA 98116-3647 - Phone
- (360) 742-7344
- NPI assigned
- Apr 15, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60524067 | WA | Primary |
Addresses
Primary practice location
5963 SW Carroll St
Seattle, WA 98116-3647
Mailing address
PO Box 16050
Seattle, WA 98116-0050
Phone (360) 742-7344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA60524067 | Other | WA | MASSAGE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60524067 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737676800000",
"number": "1669868782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16050",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981160050",
"telephone_number": "360-742-7344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5963 SW CARROLL ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981163647",
"telephone_number": "360-742-7344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIE",
"first_name": "CLEMENTINE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-15",
"last_updated": "2025-01-24",
"certification_date": "2025-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60524067",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE",
"identifier": "MA60524067",
"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 Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.